Case 7 – the beginning

As the ENT SHO you take direct admissions from the Emergency Department’s triage nurse for anything ENT related.  You get a call about a 35 year old gentleman who has had on-and-off epistaxis for the past 24 hours and is getting worse.  The A&E nurse has kindly taken some baseline bloods and the patient is taken to the ENT ward for packing after initial ABC was okay.

The lab call the ward soon after arrival with a provisional FBC:

  • Hb 100g/l (i.e. 10.0g/dL) (ref 130-180)
  • MCV 95fL (ref 82-98)
  • WCC 12.5×10*9/L (ref  4-11)
  • Platlets 21×10*9/L (ref 150-450)

Please answer the following question(s)

  1. What are your differential diagnoses?
  2. What is your initial management?

Please reply on Twitter and always include #teamhaem to allow others to follow your comments. This case is designed particularly with non-haematologists in mind so please join in the debate and learn about haematological emergencies along the way. The case will continue to  evolve over the coming week so keep checking #teamhaem for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

TeamHaem are not a position of authority.  It is an educational platform to allow discussion and debate rather than to provide medical advice.

About TeamHaem

Online education and discussion about all things haematological
This entry was posted in Acquired bleeding, Anaemia, Platelet disorders, Related to other specialities and tagged , , , , . Bookmark the permalink.

2 Responses to Case 7 – the beginning

  1. @danpelling says:

    Low plts in presence of anaemia in 35yo male worrying. Would determine cause and consider malignancy.

  2. @danpelling says:

    Do full coagulation work up. Will help determine if low plts due to consumption coagulopathy. Do LFTs. Look at peripheral blood film.

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