Smart Phrases And Workups – Hem Onc

ANEMIA	
Anemia
Micro/Normo/Macro, acute vs chronic
Admission Hgb ***, baseline ***
- f/u CBC, retic count
- RI <2%, iron panel, TIBC, ferritin, folate, B12, Cr, LFTs, TSH
- RI >2%, LDH, bilirubin, haptoglobin, DAT, UA, Coags
- transfuse for Hgb >7
HEMOLYTIC ANEMIA	Hemolytic Anemia
- f/u CBC, retic count, LDH, bilirubin, haptoglobin, DAT, UA, Coags
- transfuse for Hgb >7
HYPERCALCEMIA	
Hypercalcemia
Corrected Ca = Serum Ca + 0.8 x(4-albumin) ***
- f/u PTH, 25-Vit D, TSH
- NS @ 200-300 cc/h with goal UOP 100-150 cc/h
- furosemide
- calcitonin 4-8U/kg SC BID x38h
- zolendronate if Ca >14 or malignancy
PANCREATIC MASS	
Pancreatic Mass
Ddx: adenocarcinoma (85-90%), autoimmune pancreatitis, neuroendocrine (1-5%), lymphoma (<1%), mets (melanoma, RCC), cyst
CT A/P ***
- f/u CBC, BMP, LFTs, lipase, CA 19-9 (+ in 80% panc ca), CEA, ANA, IgG4
- f/u EUS with FNA
- consider PET
- MCRP for malignancy in IPMN
PORTAL VEIN THROMBOSIS	
SICKLE CELL DISEASE	
THROMBOCYTOPENIA	
ANEMIA
Anemia
Micro/Normo/Macro, acute vs chronic
Admission Hgb ***, baseline ***
- f/u CBC, retic count
- RI <2%, iron panel, TIBC, ferritin, folate, B12, Cr, LFTs, TSH
- RI >2%, LDH, bilirubin, haptoglobin, DAT, UA, Coags
- transfuse for Hgb >7
HEMOLYTIC ANEMIA Hemolytic Anemia
- f/u CBC, retic count, LDH, bilirubin, haptoglobin, DAT, UA, Coags
- transfuse for Hgb >7
HYPERCALCEMIA
Hypercalcemia
Corrected Ca = Serum Ca + 0.8 x(4-albumin) ***
- f/u PTH, 25-Vit D, TSH
- NS @ 200-300 cc/h with goal UOP 100-150 cc/h
- furosemide
- calcitonin 4-8U/kg SC BID x38h
- zolendronate if Ca >14 or malignancy
PANCREATIC MASS
Pancreatic Mass
Ddx: adenocarcinoma (85-90%), autoimmune pancreatitis, neuroendocrine (1-5%), lymphoma (<1%), mets (melanoma, RCC), cyst
CT A/P ***
- f/u CBC, BMP, LFTs, lipase, CA 19-9 (+ in 80% panc ca), CEA, ANA, IgG4
- f/u EUS with FNA
- consider PET
- MCRP for malignancy in IPMN
PORTAL VEIN THROMBOSIS
SICKLE CELL DISEASE
THROMBOCYTOPENIA

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