Emergency Haematology

1
Emergency Haematology
2

• You are called to see a 30y old man on Ward 2Y
  with AML, Day 15 of chemotherapy with a fever of
  38ºC.
• Hb 8.7 WBC 0.2 (Neuts 0.0) Plt 16.
• What do you do?
• What dont you do?

3

• A 70y old lady comes to MAU via Ophthalmology
  complaining of blurred vision. She has retinal
  vein thrombosis.
• Hb 8.3 WBC 4.5 Plt 332
• Total protein 110 g/l Albumin 30g/l
• What is going on?
• What should be done?

4

• The same lady comes back 1 year later with a
  history of backache, heaviness of the legs and
  difficulty passing urine.
• What do you suspect?
• What do you do?

5

• A 25y old IVDU with a history of DVT comes in
  obtunded. CT scan reveals a subdural haemorrhage.
  INR 20.
• What do you do?

6

• A 22y old South African man comes in with a
  fever of 37.5ºC and confusion.
• Hb 7.8 WBC 4.5 Plt 68
• PT 1.1 APTT 1.2 Fib 4.5g/dl
• U 23.5 Creat 350
• Blood film red cell fragments
• What do you suspect?
• What do you do?

7

• A 73y old previously fit man comes in to AAU
  with SOB and confusion.
• Hb 7.2 WBC 455 Plt 43
• What is happening?
• What needs to be done?

8

• An 80y old lady comes to SAU with a cold blue
  painful leg.
• Hb 20.5 WBC 18.0 Plt 680
• What is the diagnosis?
• How do you confirm it?
• What do you need to do?

9

• You are called by a surgical ward to say that a
  previously well post-operative patient has
  dropped her blood pressure and is now very unwell
  30 minutes into a blood transfusion.
• What do you do?
• What do you suspect and
• how would you investigate?