Hematology

Pulmonology

Questions discussed in this category

Is it necessary to prescribe a steroid taper after two weeks of high-dose prednisone (60 mg daily)?

How do you manage concurrent non-life-threatening hemoptysis and acute pulmonary embolism?

Estimating blood loss from hemoptysis is not always reliable. The bleeding may be due to the PE itself. Is anticoagulation with any degree of hemoptys...

1 Answer available

Would you consider using DOACs as a bridge to warfarin instead of heparin or LMWH?

For example, would you consider this method in an ESRD/HD patient with antiphospholipid syndrome who had a major bleed requiring reversal of warfarin ...

4 Answers available

What is your protocol for transitioning to oral anticoagulation post-thrombolysis for pulmonary embolism?

High-risk PEs are typically treated with loading doses of anticoagulants or bridging with LMWH. Do you omit the bridging/loading period and go straigh...

1 Answer available

How does your approach to subsegmental PE differ from segmental PE both diagnostically and therapeutically?

3 Answers available

In massive transfusion protocol from suspected hemorrhage, is it worth obtaining a TEG to guide transfusion?

1 Answer available

For patients with newly diagnosed VTE on IV heparin planned for transition to DOAC, would you start at the loading or maintenance DOAC dose?

If they have been on IV heparin for 3 days, for example, would you subtract those days from the recommended loading dose time?

3 Answers available

What approaches can we take to initiate therapy and improve survival rates in patients with HLH?

2 Answers available

How would you manage symptomatic, bilateral subsegmental PE developed after long air travel?

The patient takes frequent flights for their job, with no prior history of VTE, and has already been taking measures for prevention including frequent...

2 Answers available

Would you offer lung SBRT in a patient with Pulmonary Langerhans Cell Histiocytosis (PLCH)?

1 Answer available

Would you use the pneumococcal conjugate-21 vaccine (Capvaxive) instead of the conjugate-20 (Prevnar-20) for routine vaccinations in immunosuppressed patients?

2 Answers available

How would you manage a patient with morbid obesity who presents with new symptomatic pulmonary embolism a few days after he was started on DOAC for DVT?

What is your preferred anticoagulation in patients with BMI >50?

5 Answers available

In which cases would you consider early transition to DOAC (within 72 hours) for hospitalized patients with intermediate or high risk PE?

Assume thrombolytics are not indicated. Do you favor early DOAC transition after 24-48 hours of heparin gtt or do you favor LMWH for 10-14 days follow...

2 Answers available

For patients with suspected complement-mediated TMA, are there specific clinical or laboratory parameters that can help guide the decision for starting empirical treatment (e.g., eculizumab) while awaiting the results of complement testing?

1 Answer available

Are SCDs contraindicated in patients with acute DVTs?

Is it different than early mobility that we always encourage?

3 Answers available

Do you use FVIII levels to differentiate between DIC and coagulopathy of liver disease?

Common thought is that FVIII may be used for differentiating coagulopathy in liver disease (normal to increased, from reduced clearance of VWF/FVIII) ...

4 Answers available

How long post operatively do you wait before transitioning from parenteral anticoagulation to oral anticoagulants after pulmonary thromboendarterectomy for CTEPH?

2 Answers available

Would you restart prophylactic anticoagulation in a patient with a history of unprovoked PE who received short term anticoagulation with a prior physician?

E.g. low dose DOAC

1 Answer available

When can abdominal surgery be safely performed for presumptive ovarian cancer in a patient with recent pulmonary emboli?

(Normal oxygenation and echo)

1 Answer available

Are there patients who can forgo anticoagulation with asymptomatic, incidentally discovered subsegmental pulmonary embolism?

If there are a low-risk patients who can be monitored, how would you do so? If unprovoked, would you consider stopping anticoagulation?

2 Answers available

Papers discussed in this category

AJR Am J Roentgenol,

Overdiagnosis of Pulmonary Embolism by Pulmonary CT Angiography.

Blood Adv,

American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism.

CMAJ,

Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy.

Hepatology, 1996 Jun

Coagulation factor V levels as a prognostic indicator in fulminant hepatic failure.

Hepatology, 1986 Jul-Aug

Multivariate analysis of prognostic factors in fulminant hepatitis B.

Gut, 1992 Jan

Coagulation factor V and VIII/V ratio as predictors of outcome in paracetamol induced fulminant hepatic failure: relation to other prognostic indicators.

J Thromb Haemost, 2021 Jul 14

Use of direct oral anticoagulants in patients with obesity for treatment and prevention of venous thromboembolism: Updated communication from the ISTH SSC Subcommittee on Control of Anticoagulation.

Blood, 2020 Mar 19

How I treat obese patients with oral anticoagulants.

Journal of hospital medicine, 2019-01

Things We Do for No Reason: Intermittent Pneumatic Compression for Medical Ward Patients?

The New England journal of medicine, 2019 Feb 18

Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis.

Phlebology, 2020 Mar 02

Risks and contraindications of medical compression treatment - A critical reappraisal. An international consensus statement.

VASA. Zeitschrift fur Gefasskrankheiten, 2001 Jul

Therapy of deep vein thrombosis with low molecular weight heparin, leg compression and immediate ambulation.

Journal of vascular surgery, 2000 Nov

Compression and walking versus bed rest in the treatment of proximal deep venous thrombosis with low molecular weight heparin.

British journal of haematology, 2024 Sep 02

Measurement of heparin, direct oral anti-coagulants and other non-coumarin anti-coagulants and their effects on haemostasis assays: A British Society for Haematology Guideline.

Arthritis & rheumatology (Hoboken, N.J.), 2023 Jul 24

The 2022 EULAR/ACR Points to Consider at the Early Stages of Diagnosis and Management of Suspected Haemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome (HLH/MAS).

JAMA network open, 2023 Aug 01

Prevalence of and Eligibility for Surveillance Without Anticoagulation Among Adults With Lower-Risk Acute Subsegmental Pulmonary Embolism.

Blood, 2013 Jun 04

Risk profile and clinical outcome of symptomatic subsegmental acute pulmonary embolism.

Annals of internal medicine, 2021 Nov 23

Risk for Recurrent Venous Thromboembolism in Patients With Subsegmental Pulmonary Embolism Managed Without Anticoagulation : A Multicenter Prospective Cohort Study.

Respirology (Carlton, Vic.), 2018 Jul 16

Pulmonary infarction: A disease of the (mostly) young.

The Lancet. Haematology, 2021 Aug 04

Early switch to oral anticoagulation in patients with acute intermediate-risk pulmonary embolism (PEITHO-2): a multinational, multicentre, single-arm, phase 4 trial.

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 2023 Jan-Dec

Retrospective Analysis of Direct-Acting Oral Anticoagulants (DOACs) Initiation Timing and Outcomes After Thrombolysis in High- and Intermediate-Risk Pulmonary Embolism.

Lupus, 2014 Jul 30

Serious infections in systemic lupus erythematosus with a focus on pneumococcal infections.

MMWR. Morbidity and mortality weekly report, 2024 Sep 12

Use of 21-Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Recommendations of the Advisory Committee on Immunization Practices - United States, 2024.

Journal of the Endocrine Society, 2022 Dec 02

Perioperative Evaluation and Management of Patients on Glucocorticoids.

Diagnostics (Basel, Switzerland), 2021 Apr 20

Glucocorticoid Withdrawal-An Overview on When and How to Diagnose Adrenal Insufficiency in Clinical Practice.

Journal of general internal medicine, 2007-01

Air travel and venous thromboembolism: a systematic review.

Blood advances, 2018-11-27