POLYCYTHAEMIA

Question 1

Define polycythaemia.

Answer 1

an increase in haematocrit this may be primary or secondary

Question 2

What is secondary polycythaemia also known as? What sepcially causes secondary polycythaemia?

Answer 2

-REACTIVE polycythaemia
-altitude
-COPD
-increased EPO - doping, EPO secreting tumour
-smoking
-OSA
(things that mean you need better O2 carrying capacity)

Question 3

What is primary polycythaemia? What are it’s causes?

Answer 3

• ‘true polycythaemia’
• an increase in production of RBCs
• Rubra vera - myeloproliferative disorder “overactive bone marrow”
• JAK2 mutation
• 6th decade peak

Question 4

Features of polycythaemia?

Answer 4

• hyperviscosity –> thrombosis
• puritis, esp after hot bath/shower
• splenomegaly
• haemorrhage (low platelets)
• plethoric complexion (RED FACE)
• HTN
• gout due to increase turn over

Question 5

Ix for polycythaemia?

Answer 5

• FBC, haematocrit, ferritin
• JAK2 mutation testing
• renal and liver functions

Question 6

How do you treat polycythaemia?

Answer 6

treat hyperviscosity - aspirin
treat increase in RBC - venesection
stop them making more RBC - bone marrow suppression with hydroxycarbamide