Hospital Medicine   

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...

Solid tumor patients, other hematologic malignancies, patients with autoimmune diseases on immunosuppressive therapy? Do you consider workup if they a...

E.g., patients with small CNS mets without vasogenic edema or symptoms. Epidural disease without epidural spinal cord compression or asymptomatic low-...

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

Data from Massard et al., PMID 20181575 used an abbreviated 3-day course of EP with completion of EP and bleomycin at day 15. Should this approac...

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...

And if delayed, should chemotherapy be started?

How do you decide between starting infliximab, MMF, or IVIG? If a patient presents in respiratory failure (nearing or requiring intubation), woul...

E.g. in a patient with tenuous cardiac function, would starting treatment several weeks earlier potentially improve outcomes?

Given the substantial risks associated with transporting an intubated and ventilated patient to Radiation Oncology, is there any evidence to support t...

What is your preferred agent (DOAC, warfarin, enoxaparin), and is periprocedural bridging necessary?

C diff infection ruled out and CT abdomen pelvis shows diffuse enterocolitis extending far beyond the bowel-sparing IMRT radiotherapy field. 

Please specify your approach in elective and emergency surgical situations

What precautions can be taken to limit infestation of the department?   Do you implement a treatment delay and if so how do you decide when...

If not, what instructions do you give to patients regarding checking temperature at home/return precautions?

e.g. DITP from eptifibatide after a cardiac intervention

How does cirrhosis and/or underlying thrombophilia affect your decision?

E.g. disease burden causing airway or vascular compression.

Does manipulation of blood products (leukoreduction, irradiated) affect your approach? There is growing evidence that routine premedication (at least ...

Does having a concurrent consumptive process e.g. DIC change your management? 

Do you always treat with the full 21-day treatment course, or can defibrotide be stopped if certain criteria are met sooner?

Does your management change based on the type of end-organ involvement at the time of diagnosis? Are there any reports of CNS involvement with non-se...

CT scans show omental and pelvic disease.

No known cardiac risk factors 

How do you assess risk of tumor lysis syndrome, and is hydration sufficient or should hypouricemic agents be used as well?

I.e., Can day 2 Rituximab (RCHOP) or day 6 Rituximab (DA-EPOCH, Hyper CVAD) be given? Or should only Day 1 Rituximab be used with chemoimmunotherapy i...