Hematology

Hematology Consults

Practical frameworks for common inpatient and outpatient hematology questions encountered during internal medicine residency.

Anemia

Approach anemia using the hemoglobin trend, MCV, reticulocyte response, peripheral smear, iron studies, hemolysis testing, nutritional evaluation, kidney function, inflammation, and marrow assessment.

MCV approach Reticulocytes Smear
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Thrombocytopenia

Confirm the count, recognize urgent syndromes, calculate the 4Ts and PLASMIC scores, evaluate ITP, and apply current platelet-transfusion thresholds.

4Ts calculator PLASMIC score Transfusion
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Hemolysis

Confirm red-cell destruction, calculate the corrected reticulocyte response, interpret smear findings and the DAT, distinguish immune from nonimmune causes, and recognize urgent transfusion problems.

Corrected retic RPI calculator DAT interpretation
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Pancytopenia

Distinguish impaired marrow production from destruction or sequestration, identify smear emergencies, evaluate reversible causes, calculate the HScore, and determine when marrow biopsy is needed.

Reticulocyte response HScore calculator Marrow evaluation
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Coagulation Abnormalities

Interpret prolonged PT and aPTT, exclude anticoagulant interference, understand mixing studies, recognize acquired factor inhibitors, and evaluate disseminated intravascular coagulation.

Mixing studies DIC calculator Factor inhibitors
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Transfusion Reactions

Respond to suspected reactions, distinguish hemolysis, allergy, anaphylaxis, sepsis, TACO and TRALI, complete the blood-bank workup, and recognize important delayed complications.

TACO vs TRALI Immediate response Delayed reactions
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