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Mashup Score: 3Episode 100: Colorectal Cancer Series, Pt. 2 - Adjuvant Therapy in Stage III Colon Cancer — The Fellow On Call - 9 day(s) ago
Episode 100: Colorectal Cancer Series, Pt. 2 – Adjuvant Therapy in Stage III Colon Cancer This week, we kick off our discussion of adjuvant systemic treatment in colon cancer, beginning with Stage III colon cancer. We will review the evidence basis for adjuvant therapy as well as the two main chemo
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Mashup Score: 0Episode 012: Heme/Onc Emergencies, Pt. 1: SVC Syndrome - 11 day(s) ago
Listen to this episode from The Fellow on Call: The Heme/Onc Podcast on Spotify. Emergencies happen in hematology and oncology. This is a fact. But how do we manage these emergencies? Look no further. In this episode, we talk all about first oncologic emergencies: superior vena cava (SVC) syndrome.Superior vena cava syndrome: Important: although we focus on a possible malignant mass in this discussion about SVC, other things can also cause SVC syndrome. How do you know about the chronicity of someone’s possible SVC syndrome? Compare to a recent picture!Image of patient with collateralization with SVC syndrome: DOI: 10.1056/NEJMicm1311911Workup: Need to determine the etiology; imaging is important: CT of chest (CT venogram)Consider ultrasound to rule out thrombosis Get biopsy (eventually) if this is malignancy DDx of mediastinal masses: 5Ts:ThymomaTerrible lymphoma (B or T-cell)Testicular cancerTeratoma Thyroid malignancies Central line (causing occlusion) +/- clotSo now what? Yes, an a
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Mashup Score: 1Episode 099: Colorectal Cancer Series, Pt. 1 - Intro to Colorectal Cancer — The Fellow On Call - 16 day(s) ago
Episode 099: Colorectal Cancer Series, Pt. 1 – Intro to Colorectal Cancer Colorectal cancer is one of the most common cancers diagnosed each year worldwide. This highly anticipated series will take an in-depth look at this disease. In this first episode, we discuss the basics, including staging, tu
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Mashup Score: 1Episode 009: Cytopenias Series Pt. 1 - Thrombocytopenia - 23 day(s) ago
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
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Mashup Score: 1Episode 009: Cytopenias Series Pt. 1 - Thrombocytopenia - 23 day(s) ago
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
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Mashup Score: 1Episode 009: Cytopenias Series Pt. 1 - Thrombocytopenia - 23 day(s) ago
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
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Mashup Score: 1Episode 098: Understanding MRD Testing in CLL — The Fellow On Call - 1 month(s) ago
Episode 098: Understanding MRD Testing in CLL With multiple options for frontline therapy in CLL, MRD has the potential to emerge as a factor that could be considered in our decision-making algorithm for sequencing treatment options. In this week’s episode, we dive into a deeper understanding of th
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Mashup Score: 0Episode 011: Cytopenias Series Pt. 3 - Neutropenia - 1 month(s) ago
Listen to this episode from The Fellow on Call: The Heme/Onc Podcast on Spotify. In our final stop in our Cytopenias series, we discuss the ins and outs of neutropenia. This is another very commonly seen issue in the clinic and in the hospital so most definitely high yield!Why is neutropenia dangerous?Prone to infections, especially gut translocation of bacteriaDefinition of neutropenia:NORMAL: WBC 4400-11000 cells/microL; neutrophils make up 40-70% of thatNeutropenia defined by ANC: WBC (cells/microL) x percent (PMNs + bands) ÷ 100 Breakdown:Neutropenia: ANC <1500 cells/microLMild: ANC ≥1000 and <1500 cells/microLModerate: ANC ≥500 and <1000 cells/microLSevere: ANC <500 cells/microLAgranulocytosis: ANC <200 cells/microLApproach to workup: HISTORY IS KEY!Medications; examples of common culprits- Chemotherapy Methimazole Clozapine InfectionsAny infections due to bone marrow suppression Toxins Less common causes: CongenitalSevere congenital neutropenia:Diagnosed in childhood; used to
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Mashup Score: 2
Episode 097: Treatment of Relapsed/Refractory CLL This week, we continue our discussion of treatment of CLL, this time focusing on the relapsed/refractory CLL. If you have not done so, we recommend checking out our prior episodes since we will be building on these conversations!
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Mashup Score: 0Episode 010: Cytopenias Series Pt. 2 - Anemia - 1 month(s) ago
Listen to this episode from The Fellow on Call: The Heme/Onc Podcast on Spotify. We continue on our cytopenias journey, this time talking all about anemia. This is a high yield topic for anyone who sees patients, as this is something we will all see. Determining the acuity of the anemia is the most important first step. Acute drop in hemoglobin? Consider active bleeding or hemolysis. Dilutional anemia (a drop in hemoglobin following fluid resuscitation) is also on the differential but should be a diagnosis of exclusion.Remember that we normally transfuse at a hemoglobin level of 7g/dL. If the patient has active cardiac issues, we transfuse at 8g/dL. Anemia Severity> 10g/dL = mild 7g/dL to 10g/dL = moderate 4.5g/dL to 7g/dL = severe, especially if acute 1g/dL to 4.5g/dL = these are almost always chronic if patients are conscious. Think about chronic blood loss or nutritional deficiency.History: Ask about nutrition, melena, hematochezia. Note that a small amount of blood can change the c
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As always, be sure to check out our comprehensive show notes for this episode and others on our website. This week's show notes were written by TFOC team member @neilymon! There's even a nice flow diagram he put together to summarize! Link: https://t.co/Vh3eSRuo04 https://t.co/nEKspUkDK0