Polycythemia (Exam 3)

Question 1

What is polycythemia?

Answer 1

increased RBC production | above-normal number of RBCs in circulation

Question 2

What are the 3 main lab findings of polycythemia?

Answer 2

RBC > 6 million/uL | Hb = 18g % | Hct = 54 vol%

Question 3

What are the 2 types of polycythemia?

Answer 3

relative and absolute

Question 4

What is relative polycythemia?

Answer 4

loss of blood plasma = hemoconcentration (concentration of RBCs)

Question 5

What is absolute polycythemia? What is it due to?

Answer 5

actual increase in total RBC mass (absolute) | due to stem cell defect

Question 6

What are the 2 types of absolute polycythemia? Which one is more common?

Answer 6

primary absolute (polycythemia subra vera) | secondary absolute (more common)

Question 7

What is Suprious polycythemia?

Answer 7

(stress-induced) stress = increase hormone levels in circulation = diarrhea

Question 8

What are the 8 probable causes of relative polycythemia?

Answer 8

stress | decreased fluid intake | severe diarrhea | shock | vomit | burn | adrenal insufficiency | dehydration

Question 9

Which type of polycythemia is more common?

Answer 9

relative polycythemia

Question 10

What are the lab findings of relative polycythemia?

Answer 10

HIGH = RBC count, Hct, Hb | normal = MCH, MCV, MCHC

Question 11

In primary absolute polycythemia, what is the main cause of the disease?

Answer 11

stem cell defect

Question 12

How does primary absolute polycythemia lead to iron deficiency anemia?

Answer 12

increase RBC production = exhaust iron supply = iron deficient

Question 13

What other diseases can primary absolute polycythemia lead to? (In who?)

Answer 13

leukemia (in older people)

Question 14

What are the 3 causes of death from primary absolute polycythemia?

Answer 14

thrombosis | hemorrhage | leukemia

Question 15

What are the 5 characteristics of primary absolute polycythemia?

Answer 15

enlarged veins | increase number of blood cells in circulation | spleenomegaly | gradual onset slow chronic progression | begins late middle life

Question 16

Who is at high risk of getting primary absolute polycythemia?

Answer 16

males | European Jews

Question 17

What are the 4 symptoms of primary absolute polycythemia?

Answer 17

headache/dizziness | dysfunctional platelets | increased risk of thrombosis | hyperuricemia

Question 18

What causes the headache and dizziness in primary absolute polycythemia?

Answer 18

blood viscosity affects cerebral circulation = enlarged vessels in the brain

Question 19

How can gout result from primary absolute polycythemia?

Answer 19

from thrombosis | related to a high uric acid levels

Question 20

What is hyperuricemia?

Answer 20

increase uric acid due to increasing nucleic acid synthesis

Question 21

What is uric acid?

Answer 21

end product of DNA degradation

Question 22

What food should people with gout not eat?

Answer 22

internal organs since it has DNA

Question 23

What are the 3 treatment methods of primary absolute polycythemia?

Answer 23

multiple venesections (phlebotomy) | BM transplant | radiation of metabolic cells in BM

Question 24

What is secondary absolute polycythemia?

Answer 24

increase in RBCs only, not other blood cells

Question 25

What are the 5 causes of secondary absolute polycythemia?

Answer 25

high altitudes | heavy smoking | pulmonary disorders | renal disease | toxins

Question 26

What are the 3 pulmonary disorders that can lead to secondary absolute polycythemia?

Answer 26

fibrosis | emphysema | edema

Question 27

What is the common underlying physiological cause of secondary absolute polycythemia?

Answer 27

low pO2

Question 28

How can renal disease cause secondary absolute polycythemia?

Answer 28

increase erythropoietin (when not needed)

Question 29

How can nitrites cause secondary absolute polycythemia?

Answer 29

nitrites = form MetHb = decrease pO2

Question 30

What is nitrite?

Answer 30

strong oxidizing agent turning ferrous into ferric = low pO2

Question 31

How can MetHb cause arrhythmia?

Answer 31

increase heart rate

Question 32

What are the lab findings of secondary absolute polycythemia?

Answer 32

normal MCH/MCV/MCHC | high RBC count, Hct, Hb | BM normal but see mild increase of RBC precursors due to increase erythropoietin

Question 33

What is the treatment for secondary absolute polycythemia?

Answer 33

supportive (cannot address fundamental cause)