Polycythaemia

Question 1

What is polycythaemia?

Answer 1

An increase in RBC count and haemocrit

Question 2

What is absolute polycythaemia?

Answer 2

Due to an increase in RBC mass, polycythaemia vera or mutations

Question 3

What is secondary polycythaemia?

Answer 3

Due to hypoxia or high EPO secretion, high altitude/chronic lung disease or renal carcinoma

Question 4

What mutation do 95% of patients have?

Answer 4

JAK2

Question 5

How does polycythaemia present?

Answer 5

Headaches and dizziness, itching, fatigue, tinnitus, erythromelalgia, HTN, angina

Question 6

What is erythromelagia?

Answer 6

Burning sensation in fingers and toes

Question 7

In what type of polycythaemia is hepatosplenomegaly present?

Answer 7

Absolute

Question 8

What blood results would you see?

Answer 8

Raised WCC and platelets, raised haemoglobin, low serum EPO

Question 9

What would you see on a bone marrow biopsy?

Answer 9

Proliferation of granulocytes and megakaryocytes

Question 10

How do you manage polycythaemia?

Answer 10

Aim to maintain normal blood count, venesection relieves symptoms, low dose aspirin, radioactive phosphorus if over 70