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Charles Milrod, MD

Charles Milrod, MD
@CharlesMilrod

Nov 21, 2022
7 tweets
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Triage is life-and-death responsibility! First step? Recognize the emergency. 5 threads on blood cancer emergencies (and how to treat them)๐Ÿ‘‡

Acute promyelocytic leukemia ๐Ÿ†˜ 1/5
Charles Milrod, MD

Charles Milrod, MD
@CharlesMilrod

Picture this: A young woman presents with gum bleeding, and you find this ๐Ÿ‘‡ on your evaluation. Why (and how) is this an emergency? ๐Ÿค” A #tweetorial ๐Ÿงต 1/6
Petechiae
Leukostasis ๐Ÿ†˜ 2/5
Charles Milrod, MD

Charles Milrod, MD
@CharlesMilrod

Picture this: A young man presents with a WBC of 100k, and you find this ๐Ÿ‘‡ on your evaluation. Why (and how) is this an emergency? ๐Ÿค” A #tweetorial ๐Ÿงต 1/6
Bilateral infiltrates and ground-glass opacities (and endotracheal intubation)
Peripheral smear with numerous myeloid blasts
Spinal cord compression ๐Ÿ†˜ 3/5
Charles Milrod, MD

Charles Milrod, MD
@CharlesMilrod

Picture this: A patient presents with leg weakness, and you find this ๐Ÿ‘‡ on your evaluation. Why (and how) is this an emergency? ๐Ÿค” A #tweetorial ๐Ÿงต 1/6
Plasmacytoma causing T7-T9 spinal cord compression
Peripheral smear shows stacking of cells (rouleaux formation)
Tumor lysis syndrome ๐Ÿ†˜ 4/5
Charles Milrod, MD

Charles Milrod, MD
@CharlesMilrod

Picture this: A patient presents with palpitations, and you find this ๐Ÿ‘‡ on your evaluation. Why (and how) is this an emergency? ๐Ÿค” A #tweetorial ๐Ÿงต 1/7
EKG shows sine-wave pattern arrhythmia, which can be seen in severe hyperkalemia
Peripheral smear shows many blasts- later diagnosed with acute lymphoblastic leukemia
SVC syndrome ๐Ÿ†˜ 5/end
Charles Milrod, MD

Charles Milrod, MD
@CharlesMilrod

Picture this: A patient is found unconscious at home, and you find this ๐Ÿ‘‡ on your evaluation. Why (and how) is this an emergency? ๐Ÿค” ๐Ÿงต 1/8
Upper body congestion and edema
Reed-Sternberg cell- large binucleated CD30+ cell with abundant cytoplasm, characteristic of Hodgkin Lymphoma
Charles Milrod, MD

Charles Milrod, MD

@CharlesMilrod
Hematology/oncology fellow @BrownUniversity ๐Ÿป | Aspiring hematologist ๐Ÿงฌ | Interested in blood cancers, immunotherapy, and coffee ๐Ÿค™
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