History taking in haematology pts

Question 1

History of the presenting complaint

Answer 1

Most important part
You should always concentrate on this
Explore any complaints in detail
Ask relevant positive and negative questions

Question 2

Presentations: referral from haematologists

Answer 2

Immunocompromised pts
Pts with known bleeding disorders
Pts on oral anticoagulants

Question 3

Presentations: general pts seen routinely

Answer 3

Is there a bleeding disorder

Is there a haematological disorder

Question 4

Haematology directed questions

Answer 4

Anaemia
-tiredness
-SOB
-chest pain
Infections
Bleeding problems
Thrombosis

Question 5

Does this pt have a bleeding disorder?

Answer 5

Easy bruising
-size, ? life long, ? spontaneous, ? location
Bleeding after cuts
Nosebleeds (epistaxes)
Bleeding after dental extractions
Bleeding after surgical procedures
Menorrhagia

Question 6

After HPC

Answer 6

Review of systems
Past medical history
Family history
more important in haematology patients
eg sickle cell disease, thalassaemia, haemophilia
Social history
Drugs
Allergies
Smoking
Alcohol

Question 7

Drugs

Answer 7

Warfarin, Rivaroxaban, Dabigatran, Apixaban, Edoxaban
Aspirin
Clopidogrel
Cytotoxics, immunosuppresants

Question 8

Alcohol

Answer 8

If high consider liver disease and excessive bleeding