Blood & Cancer

There’s an art to taking a thorough bleeding history. In this episode, Adam Cuker, MD, director of the Hemophilia and Thrombosis Center at the University of Pennsylvania, Philadelphia, shares the most important questions to ask and the challenges in assessing risk in patients about to undergo surgery and those with active bleeding. In Clinical Correlation, Ilana Yurkiewicz, MD, of Stanford (Calif.) University, talks about delivering good news to patients.    Practice points: Always take a thorough bleeding history. Ask patients about bleeding from head to toe. Even if the basic laboratory evaluation is normal, the patient may still have a bleeding disorder. *  *  *  Assessing bleeding risk before surgery  How do you advise patients about to go into surgery who say they bruise easily? This situation comes up frequently. In the case of emergency/urgent surgery, there’s not time for a prolonged evaluation. Take a careful bleeding history: Always ask patients about any history of spontaneous bleeding. Ask abou