Hematology and Oncology

Lymphadenopathy associated with infection often develops quickly and may be painful. When due to lymphoma or malignancy, the rate of enlargement tends to be slower and can wax and wane in the case of lymphoma.If splenomegaly is present, the size (in cm) from the left costal margin must be recorded. It is important to distinguish the left kidney from the spleen when palpating a mass in the left hypochondrium...

A patient is anemic when the hemoglobin concentration in the blood is less than 13 g/dL (or hematorcit [Hct] less than 39%) in men and 12 g/dL (or Hct less than 36%) in women. The size of the red blood cells gives important clues as to the likely underlying abnormality.

Bruising and bleeding arise when there is abnormal hemostasis. Hemostasis is dependent on normal platelet number and function, an intact coagulation pathway, and normal vessel walls.

Structurally related to vitamin K, 4-hydroxycoumarins act as “false” vitamin K and prevent regeneration of reduced (active) vitamin K from vitamin K epoxide, hence the synthesis of vitamin K-dependent clotting factors. Coumarins are well absorbed after oral administration. Their duration of action varies considerably. Synthesis of clotting factors depends on the intrahepatocytic concentration ratio of coumarins to vitamin K.