Whilst most of haematology is spent looking forlornly into the empty neutrophil cupboard like old Mother Hubbard post chemotherapy, the pendulum can also swing to the other extreme. Join us as we unpack the reactive and not-so-reactive causes of a neutrophilia so you don’t get too left-shifted on the wards.

TIMESTAMPS

2:18 - Apologies to the Welsh  
3:07 - Cutoffs (arbitrary as usual)  
4:46 - Left-shift  
7:02 - Spurious neutrophilia  
7:44 - Reactive neutrophilia  
9:09 - Steroids  
13:33 - Leukemoid reaction  
15:48 - Smoking  
18:49 - Clues to MPNs  
20:01 - Chronic myeloid leukaemia  
23:11 - Other MPNs  
24:06 - Chronic neutrophilic leukaemia  
26:08 - MDS/MPN Overlaps  
28:57 - Take Home Messages  

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A lone neutrophil stands alone against a horde of gram negative bacteria. He is the last of his kind, the single granulocyte rising from the ashes of a marrow once verdant with haematopoiesis, now overrun with blasts. As the endotoxin rushes towards him, he smiles, for on the horizon he can see the glimmer of tazocin rushing through the blood vessels like Gandalf leading the Rohirrim to Helm’s Deep. While the Bloody Minded Cinematic Universe remains in pre-production, you can sate your appetite with a podcast on neutropenia for now.

TIMESTAMPS

2:21 - Cutoffs (arbitrary as usual)  
3:10 - An Overview of Granulopoiesis  
5:24 - When is neutropenia urgent?  
6:46 - History  
7:32 - Examination  
10:45 - Artefactual neutropenia  
12:40 - Nutritional causes  
13:43 - Infective causes  
14:42 - Medications  
16:22 - Marrow pathology  
19:27 - Autoimmune causes  
22:26 - Splenomegaly  
22:52 - DANC  
25:33 - Investigations  
28:26 - Management  
32:43 - Take Home Messages

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There’s a problem with billionaires at the moment. Every day, you make a hundred billion platelets. For some in our society, even that colossal quantity isn’t nearly enough. They strive ever onward for even more. Unfettered platelet production all the time forever - after all the number can only go up. But mo’ platelets leads to mo’ problems. Go on a journey with Bashar, Nick and Cale to learn how some patients can become the Bezos of platelets and accumulate more than you can possibly need or want. Don’t let us stop you having a tacky wedding though. 

TIMESTAMPS

2:24 - Cutoffs (arbitrary as usual)  
4:24 - Platelet biology  
6:11 - TPO  
7:53 - Spurious thrombocytosis  
10:50 - Reactive thrombocytosis  
12:30 - Blood loss and thrombocytosis  
13:12 - TPO Kinetics  
16:00 - Iron deficiency and thrombocytosis  
19:10 - Hyposplenism  
20:03 - Drugs  
21:54 - MPNs  
23:53 - Molecular Testing  
25:27 - Clots AND Bleeds?!  
26:58 - A General Approach  
29:17 - Can we test TPO?  
30:29 - Case Study  
31:44 - Take Home Messages  

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Are you a platelet that has been conjugated to an antibody? Sequestered in a spleen? Diluted out by too much saline? Had your precious gold stolen from you? Then you might be entitled to thrombensation! Listen to this episode to learn how we can help YOU approach thrombocytopenia.

TIMESTAMPS

 2:23 - Striking gold where you least expect it
 4:40 - Definition of thrombocytopaenia
 8:06 - What do platelets do?
 9:22 - History for thrombocytopaenia
 12:20 - Exam for thrombocytopaenia
 18:03 - Artefactual thrombocytopaenia
 21:28 - Decreased platelet production
 24:46 - Increased platelet consumption
 24:55 - ITP
 27:43 - APLS
 28:15 - HIT
 29:45 - Thrombotic microangiopathies
 32:09 - Redistribution/Sequestration
 33:41 - Dilutional causes
 34:35 - Pregnancy-Related Causes
 39:23 - Investigations
 42:05 - Platelet Transfusion Thresholds
 44:36 - Take Home Messages 

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Our half empty cup from last week has now runneth over! If having low red cells is a bad thing, then having an extremely high amount must be a good thing, right? WRONG! Join the Bloody Minded Crew  as we explore what happens when we’re on the other side of that Goldilocks zone of red cells. Remember that episode of the Simpsons where they try and force a million germs through a tiny door? It’s like that but in your capillaries.

TIMESTAMPS

2:14 - Official First Aid Advice  
2:30 - Absolute vs. relative erythrocytosis  
4:49 - What's the PCV? What's the haematocrit?  
7:30 - Signs and Symptoms  
10:49 - History for erythrocytosis  
14:02 - Causes of Secondary Erythrocytosis  
21:30 - SGLT2 Inhibitors - Another Reason to Stop Them  
25:36 - Causes of Primary Erythrocytosis  
27:20 - Polycythaemia Rubra Vera  
29:06 - Budd-Chiari Syndrome  
32:20 - Elevated Hb. What Next?  
33:48 - Labs - JAK2 + EPO  
36:10 - Case Studies - Not Pre-Ordained At All  
43:16 - Take Home Messages  

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All that blood study making you faint, fatigued and short of breath? Well, you might be anaemic but how can we tell why? Join us on our first expedition of this season of highs and lows as we take apart the full blood count one episode at a time. Let’s start with an approach to a cup half-empty of blood - anaemia! 

TIMESTAMPS

2:10 - The Motto of Haematology  
3:08 - Definitions - How low is low?  
4:24 - MCV is Key  
6:43 - TICS and RACH have BLOOD in common  
8:47 - TICS(L) - Microcytic Causes  
9:27 - Thalassaemia  
12:58 - Iron deficiency  
19:33 - Chronic disease  
22:39 - Sideroblastic anaemia  
25:35 - Lead poisoning aka med school fodder  
27:46 - RACH - Normocytic Causes  
28:01 - Renal Disease  
30:32 - Acute blood loss  
31:55 - Chronic disease back again  
32:18 - Haemolysis - Pls See Season 2  
34:46 - (Surprise Myeloma - Pls Also See Season 3)  
35:18 - BLOOD - Macrocytic Causes  
35:37 - (Except it could be retics)  
36:33 - B12 Deficiency  
38:43 - Liver Disease  
39:16 - etOh  
39:54 - fOlate Deficiency  
42:04 - Drugs/Dysplasia  
43:19 - The red cell maturation pathway  
45:28 - Megaloblastic vs. non-megaloblastic  
51:09 - Thyroid - might be a thing?  
53:03 - What's in an anaemia work-up?  
57:05 - Take Home Messages

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Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Learning to count is hard. Learning to count cells is harder. Luckily we've got an expert with us today to show us the basics. Welcome back to a new batch of episodes where we unpack the highs and lows of haematology and teach you what to do with those pesky out of range blood counts. 

But to do that we need to know where the numbers come from. We don't know, so we asked Mitchell Rawlings a senior scientist in haematology to come along and relieve of us of our ignorance. Mitch takes us through automated analysers, the principles of cell counting, and some of those mysterious other acronyms on the full blood count. 

TIMESTAMPS

1:25 - A year in review
3:09 - Haematology Made Simple
4:04 - Everyone deals with FBCs...
4:52 - Mitch Rawlings
5:48 - God that intro segment was long
9:47 - FBC Stats
10:19 - Three Letter Acronym Time
13:57 - FBC Journey from Vein to Screen
15:30 - Analyser Magic
16:40 - Coulter principle
17:56 - Ghosts in the machine
19:40 - The Differential
21:25 - Red Flags
24:43 - Haemoglobin measurement - productive destruction
26:46 - The lab doesn't hate you - please send enough blood
28:53 - Retics all day long
30:07 - Derived, measured, calculated parameters
32:15 - QC + Drift Controls
34:06 - Wrong blood in tube
36:29 - Platelet counting - citrated, manual counts
40:14 - Mixing "studies" - really bad for FBC
42:08 - The problem with aspirating clots

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Have you been asked to call for a Haematology consult and are now considering hiding in a toilet? Never fear! You can listen to this podcast from the hospital bathroom AND learn some fantastic tips and tricks to help us help you! Dr Alison Chandler is back in the studio and we're aiming for future consults with at least 50% less crying – and that’s not just for the Haem AT carrying the consult phone! 

Timestamps:

00:54 - Nick is MIA
03:06 - Picking up that phone
06:44 - Consult 1) New Thombosis
19:50 - Consult 1.1) Superficial Thrombophlebitis
22:40 - Consult 2) Deranged Coags
31:35 - Consult 3) Cytopenias
49:27 - Bonus Consult: Thrombocytosis
52:14 - Summaries

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Bashar was tasked with finding an expert to talk to about blood banking. He decided to cold-email the best transfusion-educator in the world who is probably responsible for hundreds if not thousands of haematology trainees understanding blood banking. Turns out he's an absolutely lovely guy who decided to spend an hour of his Monday morning chatting to us about podcasting, education, IgA deficiency and all the wonderful aspects of the blood bank. Join us for an hour with Dr Joe Chaffin MD, much more widely known as "The Blood Bank Guy".

For more of Dr Chaffin's excellent work, check out www.bbguy.org & The Blood Bank Guy Essentials Podcast wherever you get your podcasts

Timestamps

1:00 - Containing our excitement
3:38 - The Joe Chaffin story
8:15 - Getting into education
17:40 - Surprising moments in podcasting
22:45 - How to improve transfusion teaching
27:50 - The Blood Bank/Clinician interface
38:31 - What scares the Blood Bank Guy?
46:42 - The future of blood banking
49:53 - What to unlearn
57:19 - TA-GVH made easy
1:01:24 - Final words of wisdom

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Red cells. White cells. Platelets. Plasma. Proteins. By your powers combined I am Captain… Whole Blood? Wouldn’t it be so much easier if we could work with each of these blood components individually. After all, we have to get them in a bag to donate to people. Before we swear off transfusion for the time being, join the Bloody Minded Crew as we learn the get back to basics of the apheresis machine, the concept of plasma exchange and how the magic of technology allows us to manipulate these components separately. Why keep all of your humours mixed together if you don’t have to? Hippocrates could never.

Timestamps

0:55 - Our stupidest and best intro to date
3:10 - What is apheresis?
8:05 - Indications for apheresis
13:21 - Mechanism of apheresis
17:52 - Replacement fluids
19:23 - Physiology in plasma exchange
22:13 - Complications of plasma exchange
30:50 - Take home messages

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Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au