May 13, 2021

Hematology

Alph-and Beta-thalassemia: Rapid Evidence Review – 04/04/2022 – Remember-think about this if the patient has microcytic anemia and normal or elevated ferritin levels.

Anemia in Older Adults – 03/16/2022 – Common causes =nutritional deficiencies, chronic kidney disease, chronic inflammation, and occult blood loss from GI malignancy. If the iron supplement is being used, try a lower dose formulation which can be as effective as a higher dose and more easily tolerated.

Hereditary Hemochromatosis: Rapid Evidence Review – 09/22/2021 – Always an important topic to review, recall a key recommendation that all first-degree relatives of patients with this should be screened for the disease.

Monoclonal Gammopathy of Undetermined Significance – 12/27/2022  –  This is complicated and important, and I suggest either reading the article or saving it so it can be available to you at a later point in time.  MGUS is due to either an abnormal intact monoclonal immunoglobulin or a light chain fragment in the urine or blood. It occurs in more than 3% of patients age 50 or older, and it’s more common in men, and in black patients. MGUS is asymptomatic. There seems to be a predisposition genetically toward the development of MGUS.  There are a number of unexplained lab findings that should prompt evaluation for MGUS which include elevated sed rate, elevated total protein level, anemia, renal insufficiency, and hypercalcemia. Testing should include serum protein electrophoresis (SPEP), serum immunofixation electrophoresis, and serum free light chain assay- these 3 tests help to identify more than 97% of patients who have MGUS or a clonal plasma cell disorder.

 

Polycythemia Vera – A great, brief review of important topics.

Venous Thromboembolism – 09/23/2022 – A surprisingly easy and clear review of the topic.