RBC DISORDERS 3.2

Question 1

• Erythrocytosis
• Elevated hematocrit level above the normal range because the plasma volume is decreased
• Dehydration
• Shock
• Patients on diuretics

Answer 1

Polycythemia

Question 2

• Red cell mass high normal and the plasma volume is low normal
• Usually seen in men, with high incidence of tobacco smoking, tend to be obese and have hypertension

Answer 2

Spurious polycythemia (Stresspolycythemia; Gaisbock’s Syndrome)

Question 3

Increase in total red cell mass

Answer 3

Absolute Polycythemia

Question 4

• Due to erythropoietin production
  A. Appropriate erythropoietin production; hypoxia
  
  1. Arterial oxygen unsaturation:
     
     2. High oxygen affinity hemoglobinopathy

Answer 4

Secondary polycythemia

Question 5

Arterial oxygen unsaturation in secondary polycythemia

Answer 5

• High altitude
  
  • Pulmonary diseases
  • Cyanotic heart disease
  • Smoker’s polycythemia
  • Methhemoglobinemia
  • Hb M

Question 6

Absolute Polycythemia - Secondary

B. Inappropriate erythropoietin production

1. Neoplasms
2. Renal pathology

Answer 6

1. Neoplasms
   
   • Renal cell carcinoma
   • Cerebellar hemangioma
   • Hapatoma
   • Uterine fibroids
   • Adrenal cortical neoplasms
2. Renal pathology
   
   • Renal cysts
   • Hydronephrosis
   • Transplantation

Question 7

– excessive proliferation of erythrocytes
– Excessive proliferation of megakaryocytes
– Excessive proliferation of granulocytes

Answer 7

Panmyelosis

Question 8

Includes Polycythemia - Vera/Erythremia/ Primary Polycythemia

• Panmyelosis
• Uknown etiology

Answer 8

Absolute Polycythemia - Primary

Question 9

Polycythemia Vera/Erythremia/Primary Polycythemia

Criteria for diagnosis:
1. Increased Total RBC volume
Males
Female
2. Normal arterial oxygen
3. Either splenomegaly, of two of the following
a. thrombocytosis
b. Leukocytosis
C. NAP/LAP (leukocyte alkaline phosphatase)
D. Vitamin B12 >900ug/L or Unsaturated binding capacity > 2200 ug/L

Answer 9

Polycythemia Vera/Erythremia/Primary Polycythemia

Criteria for diagnosis:
1. Increased Total RBC volume
Males > 36 ml/Kg
Female > 32 ml/Kg
2. Normal arterial oxygen >92%
3. Either splenomegaly, of two of the following
a. thrombocytosis >400 x 109/L
b. Leukocytosis > 12 x 109/L
C. high NAP/LAP (leukocyte alkaline phosphatase
D. high Vitamin B12 >900ug/L or Unsaturated binding capacity > 2200 ug/L

Question 10

Polycythemia Vera/Erythremia/Primary Polycythemia
Other Laboratory:
Blood:
1. PBS: - 
2. Indices: Hemoglobin 
         MCH and MCHC
3. ESR

Answer 10

Polycythemia Vera/Erythremia/Primary Polycythemia
Other Laboratory:
Blood:
1. PBS: - immature leukocytes and increased basophil
2. Indices: Hemoglobin
high MCH and MCHC – normal to low
3. ESR: low

Question 11

Polycythemia Vera/Erythremia/Primary Polycythemia
Other tests:
1. Uric acid -
2. arterial oxygen saturation
Bone marrow:

Answer 11

Polycythemia Vera/Erythremia/Primary Polycythemia
Other tests:
1. high Uric acid —— renal stones
2. Normal arterial oxygen saturation
Bone marrow:
- Hypercellullar with erythroid, granulocytic, and megakaryocytic hyperplasia