All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Expert Case Description You are seeing a 56M in your critical care suite who has just arrived as a transfer from a peripheral hospital. The patient has had a recent diagnosis of acute leukemia and was given chemotherapy and a recent stem cell transplant 20 days ago at this hospital. When he started getting sicker, they requested …
Intracranial Bleeding in Seniors Who Fall
View PostBlood and Clots Series: When can patients on direct anticoagulants have surgery?
All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Professional, Collaborator, Medical expert As a Thrombosis specialist, I am often paged by emergency physicians and orthopedic surgeons requesting anticoagulation reversal in order to facilitate surgery. There are some simple and important points to remember when dealing with this clinical scenario. Case Description It is 8am on Monday morning and you are the orthopedic resident on call …
Tiny Tips: “KULT IMPACT” as a mnemonic for Anion Gap Metabolic Acidosis
Every medical student learns the differential diagnosis for an anion gap metabolic acidosis. The list is particularly crucial for emergency physicians, who often see this finding in sick, undifferentiated patients. Many people use the mnemonics “MUDPILES CAT” or “GOLDMARK” to help remember this list. An alternative mnemonic, “KULT IMPACT”, provides a practical and organized way of remembering the differential. “KULT” denotes the most common organic causes: Ketones: diabetic ketoacidosis (DKA), alcoholic ketoacidosis, starvation …
Tiny Tips: ICH for ICH – Brain Herniation
Brain herniation is a catastrophic sequela of increased intracranial pressure (ICP) or local mass effect from intracranial lesions. Different types of brain herniation can occur depending on the location of mass effect and how rapidly this mass effect develops.1 Any mass lesion, including hemorrhage, tumor, vasogenic or cytotoxic edema, trauma or infection can cause herniation. However spontaneous intracerebral hemorrhage (ICH) and traumatic brain injury (TBI) are common causes of herniation in the acute …
Blood and Clots Series: My patient has a pulmonary embolism. Should I screen them for cancer?
All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Expert, Leader Case Description An 83 year old female presents for follow-up after completing 3 months of oral anticoagulant therapy with Rivaroxaban for her unprovoked deep vein thrombosis. She did some research online and heard about a link between venous thrombosis and cancer, and asks why you are not getting a CT scan to rule out malignancy. …