Teaching Cases

ASH Teaching Cases emphasize standard approaches to classic hematologic problems and are designed to simulate the steps involved in diagnosing a patient, from taking the history and performing a physical exam, to ordering and interpreting lab tests, to making a final diagnosis and following the clinical course of the disease. While working through each case, learners are challenged to consider the right questions to ask at each step in the process. Each case includes a set of teaching points and a bibliography with links to references. To keep track of your progress in cases you’ve started, view all cases in progress in My Dashboard.

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Category I: Bleeding Disorders

I-1 - Bleeding History in a Child Undergoing Surgery

Spero R. Cataland, MD, and Eric H. Kraut, MD

A 10-year-old male is to undergo elective tonsillectomy. He experienced significant bleeding after a recent tooth extraction.

I-2 - GI Bleeding

David Green, MD, PhD

A 51-year-old woman who is scheduled for a bowel resection presents with GI bleeding.

I-3 - Hematemesis

Marc J. Kahn, MD

A 64-year-old man who has not seen a doctor for 25 years presents to the emergency department after four episodes of vomiting over the past two days. He describes the vomitus as looking like coffee grounds.

I-4 - Surgical Bleeding

Lisa Arfons, MD and Alvin Schmaier, MD

A 62-year-old female is in the recovery room after a thrombectomy. Her attending is concerned about the amount of blood draining from her chest tubes.

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Category II: Bone Marrow Disorders

II-1 - Macrocytosis

Emmanuel C. Besa, MD

A 78-year-old woman is being seen by her physician due to a macrocytosis of her red cell indices. She complains of feeling tired during the day and of sleeping more than she did in the past.

II-2 - Polycythemia

Virginia C. Broudy, MD

A 72-year-old man presents for evaluation of polycythemia.

II-3 - Fever and Petechial in an Infant

James Harper, MD

A 17-month-old boy was admitted to the hospital with a two-week history of fever (T max 104º F) and a two-day history of rash on his legs.

II-4 - Cough, Back Pain, and Fatigue

Robert A. Kyle, MD, and Michael Tomasson, MD

A 65-year-old woman experiences a sudden onset of fever, shaking chills and productive cough. She has had progressive fatigue for six months and lower back pain for several years.

II-5 - Unexplained Leukocytosis in an Adult

Eileen Scigliano, MD

A 50-year-old man presents with a two-month history of fatigue and early satiety.

II-6 - A Patient with Pancytopenia

Peter W. Marks, MD

A 34-year-old woman is referred to the emergency department after seeing her dentist for bleeding gums and is found to have pancytopenia.

II-7 - Fatigue, Dyspnea, and Abnormal Blood Counts

Katherine Walsh, MD and Eric Kraut, MD

A 45-year-old woman presents with complaints of marked fatigue and progressive dyspnea on exertion.

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Category III: Lymphoproliferative Disorders

III-1 - Lymphocytosis

Bernard Greenberg, MD

A 69-year-old man scheduled for a routine herniorrhaphy has a preoperative abnormal blood count.

III-2 - Lymphadenopathy

Jorge E. Romaguera, MD

A 60-year-old man complains of a new lump in the right groin for the past six weeks.

III-3 - Fever, Night Sweats, and Weight Loss

Peter W. Marks, MD

A 26-year-old woman seeks medical attention because she has been having fevers accompanied by drenching night sweats over the past month, during which time she has been losing weight.

III-4 - Fever and Adenopathy in a Young Man

Howard A Liebman, MD

A 19-year-old college student is seen in the student health center with four days of fever and a sore throat.

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Category IV: Platelet Disorders

IV-1 - Thrombocytopenia

Terry Gernsheimer, MD, and Michele B. Frank, MD

A 23-year-old female complains of a rash, easy bruising, nosebleeds, gum bleeding with flossing, and an unusually heavy menses.

IV-2 - Anemia and Thrombocytopenia

Shirley P. Levine, MD

A 32-year-old woman comes to the ER complaining of episodic orbital headaches, difficulty moving her tongue, difficulty speaking, and intermittent numbness of her extremities for the last week.

IV-3 - Thrombocytopenia After Coronary Bypass Surgery

Ted Wun, MD

A 58-year-old man develops a fever after coronary artery bypass surgery.

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Category V: Red Blood Cell Disorders

V-1 - Abdominal Pain and Anemia in a Child

Allison King, MD, MPH and John DiPersio, MD, PhD

A four-year-old African American boy diagnosed with sickle cell anemia by newborn screening was admitted to the hospital with abdominal pain.

V-2 - Anemia

Paul K. Schick, MD

A 45 year-old woman presents with fatigue, dyspnea, and menorrhagia.

V-3 - Anemia and Hashimoto Thyroiditis

Caroline Cromwell, MD, and Marc J. Kahn, MD, MBA

A 29-year-old woman with a history of Hashimoto thyroiditis presents with shortness of breath, fatigue and jaundice.

V-4 - Anemia and Jaundice in a Newborn

Charles T. Quinn, MD, MS

A 7-day-old girl is referred to you to determine whether her jaundice is caused by a blood disorder.

V-5 - Thrombosis and Anemia

Alvin H. Schmaier, MD

A 27-year-old African-American woman notices the sudden onset of chest pain, shortness of breath, cough, and palpitations while riding on a bus.

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Category VI: Thrombotic Disorders

VI-1 - Thrombosis

Thomas G. DeLoughery, MD, FACP, FAWM

A 20-year-old woman presents with an extensive deep venous thrombosis.

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Category VII: White Blood Cell Disorders

VII-1 - Sore Throat, Fever, and Hyperthyroidism

Kenneth S. Cohen, MD

A 49-year-old woman presents with a sore throat and fever.

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