Internal Medicine

Practice is variable in the community, with some hematologists frequently prescribing ESAs for severe anemia that is mostly inflammatory. Do the risks...

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What are the factors that you would consider for the use of ESA in patients with anemia of CKD with a history of stroke or TIA?

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Would you recommend use of ESA for anemia of kidney disease in the setting of metastatic solid tumor malignancy?

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Should all patients diagnosed with B12 deficiency get a baseline EGD?

Should they be placed on routine EGD surveillance and if yes at what intervals?

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What is your ferritin threshold to prescribe iron to female adolescent athletes who have symptomatic iron deficiency without anemia?

What is the ideal approach for female adolescent athletes if they have complaints of fatigue and dizziness and are diagnosed with mild iron deficiency...

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At what ferritin threshold would a patient with anemia of inflammation or malignancy no longer benefit from iron supplementation for functional iron deficiency?

For example, if TSAT is less than 20% but ferritin is over 200.

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Would you give IV iron for low TSAT in patients with MDS anemia who are transfusion independent but on an ESA?

i.e. similar to CKD anemia?

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How soon do you anticipate response to cyclosporine in red cell aplasia and what cyclosporine trough levels do you target?

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Is an elevated CRP an expected finding in an otherwise healthy patient with hemoglobin S - alpha thalassemia?

CRP 39 mg/L (normal < 10) and normal ESR

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Does normal methylmalonic acid levels absolutely rule out vitamin B12 deficiency?

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How do you manage patients who develop minor antigen antibodies and require multiple blood transfusions?

e.g. K, Fya, s, etc

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Would you retry rituximab in steroid refractory warm autoimmune hemolytic anemia which responded to rituximab before?

Last rituximab 6 months ago

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Would you check vitamin B6 routinely in the work up of anemia?

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Do you routinely check for copper deficiency as part of workup for bicytopenia with leukopenia/anemia or pancytopenia?

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In your practice, do you usually check MMA and B12 simultaneously or start with B12 levels and check MMA only if indeterminate?

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Would you offer a complement inhibitor to a minimally symptomatic PNH patient with mild non-transfusion dependent hemolytic anemia?

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Do you routinely obtain bone marrow biopsy in newly diagnosed autoimmune hemolytic anemia when working up potential underlying etiologies?

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What is the transfusion management of a sickle cell patient during pregnancy?

What are your target goals during transfusion, either prophylactically or during acute complication? Does your management change between vaginal deliv...

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How can healthcare providers better serve as allies of the sickle cell community?

Has your medical practice taken any steps either in community outreach or within the clinic to show support for this medically vulnerable population, ...

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How do you workup erythrocytosis with a normal or elevated serum erythropoietin?

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How do you approach the management of a patient with symptomatic iron deficiency anemia who is intolerant of iron?

Such as a patient who cannot tolerate oral iron and has had a anaphylaxis to intravenous iron

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When would you consider splenectomy or other immunosuppressive/cytotoxic therapy for steroid-refractory warm autoimmune hemolytic anemia?

For example, in a patient who is steroid-refractory, requiring regular transfusion, and has not had response to rituximab after several weeks.

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