Clinical QuickieHematology/Coagulation
Platelets
Trend first. Panic second.
Verify the Count
Platelet clumping can create pseudothrombocytopenia.
If the result does not fit, repeat appropriately and review the smear.
Trajectory Matters
Stable chronic mild thrombocytopenia is different from a rapid fall.
Even a count still inside the reference range can be meaningful if it dropped abruptly.
Look Beyond Bleeding
Assess thrombosis as well as bleeding.
Review the rest of the CBC/smear, medications, alcohol, liver disease, infection, autoimmune disease, pregnancy context and heparin exposure.
Mechanism Organizes the Differential
Think decreased production, increased destruction/consumption, splenic sequestration, dilution or laboratory artifact.
Mechanism-first thinking prevents anchoring on a single cause.
Want more depth?
Read the Deep Dive