polycythaemia

Question 1

what is polycythaemia

Answer 1

increased levels of RBCs => increased hyperviscosity of blood => increased risk of clotting

Question 2

types of polycythaemia

Answer 2

primary - polycythaemia vera
secondary- increased RBC production in response to low oxygen

Question 3

what is polycythaemia vera

Answer 3

myeloproliferative disease where there is increased proliferation of immature cells in bone marrow => increased production of abnormal RBCs (+/- WCC and platelets)

Question 4

causes of secondary polycythaemia

Answer 4

high altitudes
OSA
cancer
heart/lung disease

Question 5

symptoms of polycythaemia

Answer 5

itching after hot showers (PV)
headaches
dizziness
blurred vision
sweating
purple earlobes/nose/palms
fatigue

Question 6

investigations of polycythaemia

Answer 6

Obs - low O2
FBC - raised RBC
bone marrow biopsy (look for cancers)
bone marrow genetic testing for JAK2 mutations

Question 7

management of polycythaemia vera

Answer 7

phlebotomy (remove blood)
myelofibrotic drugs (hydroxyurea)
aspirin (prevent clots)
antihistamines for itching
2. JAK2 inhibitors

Question 8

management of secondary polycythaemia

Answer 8

treat cause
give oxygen + fluids
OSA => surgery
aspirin/antihistamines

Question 9

complications of polycythaemia

Answer 9

clotting => stroke/MI
heart disease/ angina
splenomegaly