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CLINICAL PREDICTION RULE FOR DIC The ISTH DIC scoring system helps distinguish overt DIC from other causes of coagulopathy. Points for platelet count, PT prolongation, fibrinogen, and D-dimers. Score ≥5 = overt DIC Simple, practical, and widely used. #Hematology #DIC #ISTH

DIC CLASSIFICATION SCHEMES

I posted a poll asking whether you consider DIC a type of TMA or reserve TMA for MAHA + platelet-rich clots like in TTP/HUS. Results were evenly split. I lean toward lumping them—mostly because it's easier to lump than split when thinking about classifications like non-immune HA

PHYSICAL EXAM IN HIT May be subtle. Look closely! Skin necrosis at injection sites, limb ischemia, or signs of thrombosis (e.g. swollen leg, cold digits) can all be clues. Don't rely on bruising or bleeding. HIT is a prothrombotic state. #Hematology #HIT #PhysicalExam

67M, Chinese, ferritin 700-800 µg/L x5y Otherwise well. No symptoms/signs of liver disease, EtOH use, inflammation, and no history of RBC transfusions. CBC/LFTs, CRP, TSAT all normal. Up to date with age-appropriate cancer screening. What’s your next step? 🤔

Platelets may be tiny, but they carry serious cargo. Packed with granules, they deliver: 🎯 Clotting factors 🧬 Growth factors 🔥 Inflammatory mediators 🔬 Even RNA & mitochondria Not just cell fragments... they’re mobile delivery systems! #Platelets #Hematology #CellBiology

THROMBOCYTOSIS Most cases are reactive (85%), due to infection, inflammation, iron deficiency, asplenia. Only 15% are clonal, linked to myeloproliferative neoplasms like ET or PV. 📊 Know the difference. Think before you refer. #Hematology #MedTwitter #Thrombocytosis

DIC PATHOPHYSIOLOGY DIC is a paradox: clotting + bleeding. It starts with tissue factor exposure, triggering the extrinsic pathway → fibrin clots form throughout the body. But clotting factors & platelets get consumed, and fibrinolysis ramps up, leading to bleeding.

True or false: Essential thrombocythemia (ET) is a type of cancer.

PHYSICAL EXAM IN HIT Don’t expect bleeding. Look for thrombosis. 🔺 Skin necrosis at injection sites 🔺 Swollen, tender limbs (DVT) 🔺 Cold, pulseless extremity (arterial clot) 🔺 Signs of PE, stroke, or organ ischemia Falling platelets + clot? Think HIT. #Hematology