1/9
Dear #medicine residents
When you are confronted with a High Platelet Count
How to make sense out of it
Keep reading
#medtwitter #MedEd #medstudenttwitter #medicalstudents
Dear #medicine residents
When you are confronted with a High Platelet Count
How to make sense out of it
Keep reading
#medtwitter #MedEd #medstudenttwitter #medicalstudents
2/9
Common Things are Common First!
Think Secondary Causes
1️⃣ Infection
2️⃣ Inflammation
3️⃣ Recent Surgery / Trauma
4️⃣ Medications: Steroids
5️⃣ Connective Tissue Disorders
6️⃣ Malignancy
Common Things are Common First!
Think Secondary Causes
1️⃣ Infection
2️⃣ Inflammation
3️⃣ Recent Surgery / Trauma
4️⃣ Medications: Steroids
5️⃣ Connective Tissue Disorders
6️⃣ Malignancy
3/9
When You Assess Clinically / Think Logically
1️⃣ Take a Good History
2️⃣ Medications History
3️⃣ Bleeding / Menstrual History
4️⃣ Microvascular Symptoms
5️⃣ Any Previous Surgery/VTE/Stroke
6️⃣ Red Flag Symptoms / B Symptoms
7️⃣ Examination: Assess for Organomegaly/Lymphadenopathy
When You Assess Clinically / Think Logically
1️⃣ Take a Good History
2️⃣ Medications History
3️⃣ Bleeding / Menstrual History
4️⃣ Microvascular Symptoms
5️⃣ Any Previous Surgery/VTE/Stroke
6️⃣ Red Flag Symptoms / B Symptoms
7️⃣ Examination: Assess for Organomegaly/Lymphadenopathy
4/9
Request The following Investigations as appropriate
1️⃣ Full Blood count
2️⃣ Blood Film
3️⃣ Urea & Electrolytes
4️⃣ Liver Function Tests
5️⃣ CRP / LDH / ESR / Autoimmune Profile
6️⃣ Ferritin / Iron Studies
7️⃣ Radiology i.e. CT Scan is needed
Request The following Investigations as appropriate
1️⃣ Full Blood count
2️⃣ Blood Film
3️⃣ Urea & Electrolytes
4️⃣ Liver Function Tests
5️⃣ CRP / LDH / ESR / Autoimmune Profile
6️⃣ Ferritin / Iron Studies
7️⃣ Radiology i.e. CT Scan is needed
5/9
On a Blood Film
👉 If Hypochromic Microcytic/ Pencil Cells / Thrombocytosis ➡️ Likely IDA
👉If Reactive Features like Activated Neutrophils / Monocytes / High Platelets ➡️ Likely Infection
👉Anisothrombia / Eosinophila / Basophils ➡️ Possible MPD
On a Blood Film
👉 If Hypochromic Microcytic/ Pencil Cells / Thrombocytosis ➡️ Likely IDA
👉If Reactive Features like Activated Neutrophils / Monocytes / High Platelets ➡️ Likely Infection
👉Anisothrombia / Eosinophila / Basophils ➡️ Possible MPD
6/9
Now above causes dont fit
Then Ask Yourself could this be Primary Myeloproliferative Disease
Then Do the Following
1️⃣ Assess Microvascular Symptoms (Pins/Needles - Hands or feet)
2️⃣ Any Previous VTE / Stroke
3️⃣ Send an Urgent EDTA Sample for JAK2/CALR/MPL
4️⃣ Refer to Haem
Now above causes dont fit
Then Ask Yourself could this be Primary Myeloproliferative Disease
Then Do the Following
1️⃣ Assess Microvascular Symptoms (Pins/Needles - Hands or feet)
2️⃣ Any Previous VTE / Stroke
3️⃣ Send an Urgent EDTA Sample for JAK2/CALR/MPL
4️⃣ Refer to Haem
7/9
➡️ Urgent Referral Criteria
1️⃣ Persistent thrombocytosis >600 (>3mths apart), no reactive cause
2️⃣ Persistent thrombocytosis >450 in patients with an acute clot (arterial or venous)
➡️ Routine Referral
1️⃣ Persistent thrombocytosis >450 for at least 3 months (Nil Reactive)
➡️ Urgent Referral Criteria
1️⃣ Persistent thrombocytosis >600 (>3mths apart), no reactive cause
2️⃣ Persistent thrombocytosis >450 in patients with an acute clot (arterial or venous)
➡️ Routine Referral
1️⃣ Persistent thrombocytosis >450 for at least 3 months (Nil Reactive)
8/9
I hope you've found this thread helpful.
Thank You for Reading :)
Follow me @MorphologyAmigo for more.
Like/Repost
Follow Me Also on morphologyamigo.substack.com
I hope you've found this thread helpful.
Thank You for Reading :)
Follow me @MorphologyAmigo for more.
Like/Repost
Follow Me Also on morphologyamigo.substack.com
9/9 You can read the unrolled version of this thread here: typefully.com
@nihardesai7 @bloodworkapp @eskazanae @acweyand @HermelinMD @KMirza @BloodScientist
@nihardesai7 @bloodworkapp @eskazanae @acweyand @HermelinMD @KMirza @BloodScientist
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