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FINDINGS THAT MAY LEAD TO A HEMATOLOGY CONSULTATION
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Table 1–1 lists abnormalities that often require an evaluation by a hematologist.
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The care of a patient with a hematologic disorder begins with eliciting a medical history and performing a thorough physical examination. Certain parts of the history and physical examination that are of particular interest to the hematologist are presented here.
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HISTORY OF THE PRESENT ILLNESS
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Estimation of the "performance status" helps establish the degree of disability and permits assessment of the effects of therapy (Tables 1–2 and 1–3).
Drugs and chemicals often induce or aggravate hematologic diseases; drug use or chemical exposure, intentional or inadvertent, should be evaluated. One should inquire about professionally prescribed and self-prescribed drugs, such as herbal remedies. Occupational exposures should be defined.
Fever may result from hematologic disease or, more often, from an associated infection. Night sweats suggest the presence of fever. It is especially prevalent in lymphomas.
Weight loss may occur in some hematologic diseases.
Fatigue, malaise, lassitude, and weakness are common but are nonspecific symptoms and may be the result of anemia, fever, or muscle wasting associated with hematologic malignancy or neurologic complications of hematologic disease.
Symptoms related to specific organ systems or regions of the body may arise because of involvement in the basic disease process, such as spinal cord compression from a plasmacytoma, ureteral or intestinal obstruction from abdominal lymphoma, or stupor from exaggerated hyperleukocytosis in chronic myelogenous leukemia.
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