Hematologic

Advanced hematological management requires the clinician to interpret complete blood count panels, coagulation studies, and peripheral blood smears within the clinical context, and to prescribe and monitor anticoagulation therapy. Iron deficiency anemia presents with microcytic hypochromic red blood cells, low serum ferritin (most sensitive marker), low serum iron, elevated total iron-binding capacity (TIBC), and low transferrin saturation — distinguishing it from anemia of chronic disease (normal or elevated ferritin, low TIBC) and thalassemia trait (target cells, normal ferritin) is essential for appropriate treatment. Anticoagulation management requires understanding the mechanism, monitoring parameters, and reversal agents for each class: warfarin (vitamin K-dependent factor inhibition, monitored by INR with target 2-3, reversed by vitamin K and PCC), heparin (antithrombin III potentiation, monitored by aPTT, reversed by protamine sulfate), and DOACs (dabigatran reversed by idarucizumab, rivaroxaban/apixaban reversed by andexanet alfa). Disseminated intravascular coagulation (DIC) represents simultaneous clotting and bleeding due to widespread thrombin generation, characterized by prolonged PT/aPTT, low fibrinogen, elevated D-dimer, and thrombocytopenia.