Background: Thrombocytopenia is common in hospitalized patients. Heparin Induced thrombocytopenia (HIT) is a life threatening condition which can lead to extensive thrombosis. Diagnosis of HIT relies on clinical suspicion determined by 4T score, and the immunoassays through testing for anti PF4/Heparin antibodies. Clinical practice guidelines published by the American Society of Hematology (2013) recommended to [...]

Background:  Recent Center for Medicare and Medicaid Services (CMS) rules require hospitals to have their physicians submit inpatient admission orders and certification prior to a patient’s discharge in order to justify hospitalization reimbursement; however, CMS does not specify how hospitals are to achieve this regulation. Use of Health Information Technology (HIT) tools has significantly expanded, [...]

Background: Heparin-Induced Thrombocytopenia (HIT) is a rare (0.1-1% of heparinized medical patients) but devastating (up to 10% mortality) side-effect of heparin administration[1].  In thrombocytopenic patients, the pre-test probability of HIT is estimated by the validated “4Ts Score”, which is used to risk-stratify patients into Low (0-3 points), Intermediate (4-5 points), and High (6-8 points) likelihoods [...]

Case Presentation: A 49 year old Hispanic male presented with epigastric abdominal pain for 2 months, nausea and vomiting without a significant past medical history. He rarely consumed alcohol and denied any recent trauma. He presented one month earlier with similar symptoms and due to noted cholelithiasis on abdominal ultrasound, he was diagnosed with gallstone [...]