HEMATOLOGY FOR PRIMARY-CARE PHYSICIANS

Many hematologic disorders present minimal physical signs and symptoms in the early state. For example, chronic myelogenous leukemia may not manifest splenomegaly or any obvious physical signs, yet the laborato ry report may demonstrate leukocytosis, eosinophilia, basophilia, and thrombocytosis. Although the anemic condition of a patient with a hemo globin level of 7 gm/dl may be readily apparent to the clinician, a he moglobin level of 10.5 gm/dl may be difficult to discern during a brie f visit that is focused on another organ system. The same laboratory r eport, however, may contain valuable clues about unsuspected anemia re lated to mean corpuscular volume or morphology. Information from suppo rting chemistry studies often may be helpful in interpretation of the diagnosis. An elevated uric acid level, for example, may indicate hype rkinetic cytogenesis related to myeloproliferative or lymphoproliferat ive neoplastic disorders. This monograph is designed to be useful to b usy physicians who want to use basic hematologic studies in a cost-eff ective manner. Hematology is viewed in a problem-oriented way; the lab oratory report is used as the problem generator.