Polycythemia - Capsule cases

Question 1

Signs on blood test

Answer 1

High hb
High platelets
High white cell count 
Low MCV if iron deficient 
Raised Hct (percentage of red cells in the blood)

Question 2

CML presentation

Answer 2

Raised platelet
Raised neutrophils and myelocytes (neutrophil precursors)
Normal hb

Question 3

Anaemia blood cancers

Answer 3

Myelofibrosis

Myeloma

Question 4

causes of polycythemia

Answer 4

PKD
HCC
Polycythemia vera JAK2 gene
COPD (tissue hypoxia)

Question 5

What kind of anemia does hypothyroidism cause?

Answer 5

Macrocytic

Question 6

Investigations for polycythemia

Answer 6

Ultrasound abdomen (splenomegaly/renal carcinomas)

Question 7

Why might someone with polycythemia present with a TIA?

Answer 7

Hyperviscosity of blood and raised haematocrit

Question 8

Treatment

Answer 8

Venesection
Aspirin therapy
Cytoreductive therapy

Question 9

Why do you not give anti coag?

Answer 9

No indication - you give anti coag if there is a risk of clotting, but here it is more that you want to stop the platelets from clumping together over the hyperviscous blood so you give antiplatelets…