Episode 009: Cytopenias Series Pt. 1 – Thrombocytopenia
Listen to this episode from The Fellow on Call: The Heme/Onc Podcast on Spotify. One of our most common consults in hematology is teams seeking guidance for workup and management of thrombocytopenia. In this episode, we cover our approach to this hematologic conundrum. Major Points Covered:Thrombocytopenia is defined as a platelet count <150K- Mild: 100-150K- Moderate: 50-100K- Severe: <50K- We get really worried when <20K (risk of spontaneous bleeding) What to ask in history and in chart review: – How quickly did the platelets drop – this is just as important as the absolute number; platelets may still be “normal” but have dropped significantly!- Mucosal bleeding? Menstrual bleeding?- Rashes?- Infections/Meds/Toxins?- Constitutional symptoms- Weight loss Our approach to a differential diagnosis – analogous to everyone’s favorite approach to renal AKI: “pre”, “intra,” and “post”:Pre: Infections/Meds/Toxins- 1st: HIV, Hepatits – 2nd: EBV, CMV, Histoplasmosis Intra: Primary bone marrow f