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An important lesson learned today: Newly discovered thrombocytopaenia without bleeding should not automatically prompt platelet transfusion. Identifying the underlying cause is more important, particularly in new-onset thrombocytopaenia. A peripheral blood film is a useful early investigation and may provide important diagnostic clues. Some causes of thrombocytopaenia, such as thrombotic thrombocytopaenic purpura (TTP), generally contraindicate platelet transfusion as it may worsen thrombosis, unless there is life-threatening bleeding. #GIM #ED ❤24👍1

"60 years old female with history of recurrent stroke,  admitted for orthostatic pneumonia. She is unable to speak since few years ago after stroke. On day 3 of admission, informed by staff nurse the patient has persistent elevated blood pressure. Abdominal examination by the attending doctor noted suprapubic distension. Urinary cathether was inserted and about 1 liter of urine was drained. BP subsequently was back to normal." We always encounter patients with elevated blood pressure in the ward. What are some of the very common inpatient causes that need to be considered? - Pain - Agitation