#136 Sickle Cell Disease, Management & Complications

Stuck on sickle cell disease? We hammer out the basics of diagnosis, common sickle cell variants and their manifestations, preventive medicine, acute and chronic pain management, opioid use, and how to recognize and treat common complications like anemia, fever and acute chest syndrome. Sickle cell expert, Sophie Lanzkron MD, Associate Professor of Medicine and Oncology and Director of the Sickle Cell Center for Adults at Johns Hopkins joins!

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Sponsor

ACP's Internal Medicine Meeting 2019 April 11-13th in Philadelphia, PA. We'll see you there!

Credits

Written (including CME questions) and produced by: Justin Berk MD, Martha Brucato MD PhD, Beth Garbitelli MS1

Hosts: Paul Williams MD, Justin Berk MD, Matthew Watto MD

Edited by: Matthew Watto MD

Guest: Sophie Lanzkron MD MHS

Time Stamps

• 00:00 Announcements, intro
• 02:30 A quick refresher on hemoglobinopathy
• 03:45 Guest bio
• 05:03 Guest one-liner, movie recommendation, career advice, picks of the week
• 10:53 ACP Internal Medicine Meeting 2019 (ad read)
• 12:33 Clinical case; defining sickle cell; pathophysiology
• 16:23 Different types of hemoglobinopathy genotypes and phenotypes
• 20:20 Preventive care for sickle cell disease
• 22:56 Taking a history at the initial visit in patient with sickle disease
• 26:40 Life expectancy in SCD
• 28:30 Hydroxyurea
• 30:40 Chronic red blood cell transfusion therapy; complications; monitoring
• 37:07 Silent cerebral infarcts and mild cognitive impairment in SCD
• 40:10 Chronic pain management; opioid use disorder in sickle cell disease
• 46:00 Acute pain crisis management; PCAs vs bolus therapy
• 54:08 Reticulocyte count in sickle cell disease
• 55:40 Itching, opioids and naloxone?
• 58:10 Red blood cell transfusion threshold in sickle cell disease (anemia)
• 60:03 Acute fever in SCD
• 61:48 Acute chest syndrome
• 66:45 Transition from pediatrics to adult medicine in sickle cell
• 68:00 Incentive spirometry to prevent acute chest syndrome
• 68:45 Take home points
• 70:00 Outro