Eyrthrocytosis

Question 1

Polycythemia vera

Answer 1

Increased production of all cell lines.

RBCs, WBCs, PLTs

Question 2

Polycythemia vera Signs and Symptoms

Answer 2

HA, DIZZINESS, TINNITUS, BLURRED VISION, AND FATIGUE, PRURITIS (HISTAMINE RELEASE FROM BASOPHILS), EPISTAXIS

Question 3

Polycythemia vera Physical exam findings

Answer 3

PLETHORA AND ENGORGED RETINAL VEINS.

SPLEEN PALPABLE

Question 4

Complications of Polycythemia vera

Answer 4

THROMBOSIS IS MOST COMMON COMPLICATION. INCREASED BLOOD VISCOSITY AND ABNORMAL PLATELET FUNCTION. INCREASED BLEEDING ALSO OCCURS. BE CAREFUL WITH SURGERY

Question 5

Lab findings of PV

Answer 5

CRIT ABOVE NORMAL, AT TIMES > 60%. RBC MORPHOLOGY IS NORMAL. WBCS AND PLATELETS INCREASED ALSO, ALONG WITH BASOPHILS AND EOSINOPHILS. EPO LEVELS LOW. JAK2 MUTATION

Question 6

Secondary cause of PV

Answer 6

SMOKING, HYPOXIA. RENAL CT TO LOOK FOR EPO-SECRETING CYST OR TUMOR

Question 7

Differential for PV

Answer 7

WBC > 30,000 SUGGESTS CML. ABNORMAL RBC MORPHOLOGY, MYELOFIBROSIS. ESSENTIAL THROMBOCYTOSIS IS SUSPECTED IN PLATELET COUNT IS STRIKINGLY ELEVATED

Question 8

Treatment of PV

Answer 8

PHLEBOTOMY (can cause IDA). HYDROXYUREA. MYELOSUPPRESSIVE THERAPIES. ASPIRIN

Question 9

What are signs of secondary PV?

Answer 9

NO SPLENOMEGALY, HIGH CRIT NEEDS TO BE ACCOMPANIED BY OTHER CELL LINES.