Posts Tagged ‘hematology/oncology’

A Bruising Loss

Posted by • July 7th, 2016

Whereas inherited clotting-factor deficiencies are typically clinically evident from birth, the sudden appearance of a bleeding diathesis in a previously healthy adult is suggestive of an acquired factor inhibitor. Although inhibitors to most of the major clotting factors have been described, factor VIII inhibitors are the most common; however, factor VIII inhibitors are still rare,… Read More…

A Woman with Psychosis

Posted by • May 13th, 2016

The combination of malabsorption and autoimmunity strongly suggests the possibility of celiac disease, which is not always associated with gastrointestinal symptoms. Although neurologic and psychiatric symptoms of celiac disease are not widely recognized, they have been reported. Examination of a 37-year-old woman with adult-onset psychosis revealed weight loss, a thyroid nodule, anemia, and micronutrient deficiencies. Diagnostic tests… Read More…

Aphasia during a Transatlantic Flight

Posted by • April 28th, 2016

In more than 60% of patients with ischemic stroke, the cause is readily established and is most often atherosclerosis or heart disease. However, in a young patient with no traditional vascular risk factors and a large clot burden, the search can be broadened to include, at minimum, thrombophilia, arterial dissection, paradoxical embolism, and unusual arteriopathies. A… Read More…

A Man with Sickle Cell Disease and Headache

Posted by • April 1st, 2016

Approximately 17% of patients with sickle cell disease have cerebrovascular symptoms; 75% of those patients have cerebral infarction, 20% have either cerebral or subarachnoid hemorrhage, and a small percentage have cerebral sinovenous thrombosis. A 22-year-old man with sickle cell disease presented with headache and difficulty speaking after smoking marijuana. He had anomia, apraxia, and alexia and was… Read More…

A Man with Dyspnea and Chest Pain

Posted by • March 25th, 2016

In every patient with a large pulmonary embolus, one may consider the possibility that the embolus is caused by a benign cardiac tumor, primary cardiac cancer, or a metastasis to the heart. A 29-year-old man presented with severe dyspnea and chest pain on the right side. Computed tomographic angiography revealed a filling defect in the main and… Read More…