DUNPHY PRIMARY CARE QUESTIONS
AND CORRECT ANSWERS
What is the clinical presentation of Polycythemia Vera? ✅✅CORRECT ANSW--Median age of onset
in 60 years old
-More common in men
-Expanded red cell volume
-Symptoms develop SLOWLY, over time
Does polycythemia vera cause RBC, HCT, and HGB to be too high or too low? ✅✅CORRECT ANSW-
Too high
Does polycythemia vera respond to aspirin? ✅✅CORRECT ANSW-yes it decreases EPO
does NOT have an effect in secondary polycythemia vera
Can polycythemia vera manifest as pulmonary or cardiac disease? ✅✅CORRECT ANSW-Yes
Patient presents with chest pain, headache, tinnitus, blurred vision, weakness, and malaise? Who am
I? ✅✅CORRECT ANSW-Polycythemia Vera
Is polycythemia vera primary or secondary? ✅✅CORRECT ANSW-Primary -- it is neoplastic
proliferation of mature myeloid cells, mainly RBCs
What do labs look like with polycythemia vera? ✅✅CORRECT ANSW-Elevated RBC, HGB, HCT
What gene mutation confirms diagnosis in 95% of cases of Polycythemia Vera? ✅✅CORRECT
ANSW-JAK2 V617
Secondary causes of polycythemia vera? ✅✅CORRECT ANSW-Smoking, hypoxia, erythropoietin
secreting cyst of tumor
Does secondary polycythemia vera have splenomegaly? ✅✅CORRECT ANSW-No
, With polycythemia vera, pruritus after warm baths is caused by what? ✅✅CORRECT ANSW-
basophilia releases histamine
What are some physical exam finding in Polycythemia Vera? ✅✅CORRECT ANSW-Easy bruising,
viscous blood, deep red appearance, epistaxis, splenomegaly (75% cases), thrombosis
Polycythemia vera initial labs: ✅✅CORRECT ANSW-CBC with diff
-high WBC
-immature and elevated basophils*
-Increased platelets
-peripheral blood smear
Other labs
-coagulation work up. LFTs. Iron. Ferritin. B12 (may be elevated)
polycythemia vera treatment ✅✅CORRECT ANSW-•Treat underlying cause
•Phlebotomy
•Myelosuppression if phlebotomy not adequate
•Histamines for pruritus
•Allopurinol if gout a problem
•Aspirin unless contraindicated
•Splenectomy
-1 unit phlebotomy removed weekly
-Can use hydroxurea for myeloproliferative problem
Patients suspected with polycythemia vera should always be referred to a? ✅✅CORRECT ANSW-
Hematologist
Lymphadenopathy (LAD) ✅✅CORRECT ANSW-Pathologic enlargement ensues when inflammation
or infiltration overtakes the node.
AND CORRECT ANSWERS
What is the clinical presentation of Polycythemia Vera? ✅✅CORRECT ANSW--Median age of onset
in 60 years old
-More common in men
-Expanded red cell volume
-Symptoms develop SLOWLY, over time
Does polycythemia vera cause RBC, HCT, and HGB to be too high or too low? ✅✅CORRECT ANSW-
Too high
Does polycythemia vera respond to aspirin? ✅✅CORRECT ANSW-yes it decreases EPO
does NOT have an effect in secondary polycythemia vera
Can polycythemia vera manifest as pulmonary or cardiac disease? ✅✅CORRECT ANSW-Yes
Patient presents with chest pain, headache, tinnitus, blurred vision, weakness, and malaise? Who am
I? ✅✅CORRECT ANSW-Polycythemia Vera
Is polycythemia vera primary or secondary? ✅✅CORRECT ANSW-Primary -- it is neoplastic
proliferation of mature myeloid cells, mainly RBCs
What do labs look like with polycythemia vera? ✅✅CORRECT ANSW-Elevated RBC, HGB, HCT
What gene mutation confirms diagnosis in 95% of cases of Polycythemia Vera? ✅✅CORRECT
ANSW-JAK2 V617
Secondary causes of polycythemia vera? ✅✅CORRECT ANSW-Smoking, hypoxia, erythropoietin
secreting cyst of tumor
Does secondary polycythemia vera have splenomegaly? ✅✅CORRECT ANSW-No
, With polycythemia vera, pruritus after warm baths is caused by what? ✅✅CORRECT ANSW-
basophilia releases histamine
What are some physical exam finding in Polycythemia Vera? ✅✅CORRECT ANSW-Easy bruising,
viscous blood, deep red appearance, epistaxis, splenomegaly (75% cases), thrombosis
Polycythemia vera initial labs: ✅✅CORRECT ANSW-CBC with diff
-high WBC
-immature and elevated basophils*
-Increased platelets
-peripheral blood smear
Other labs
-coagulation work up. LFTs. Iron. Ferritin. B12 (may be elevated)
polycythemia vera treatment ✅✅CORRECT ANSW-•Treat underlying cause
•Phlebotomy
•Myelosuppression if phlebotomy not adequate
•Histamines for pruritus
•Allopurinol if gout a problem
•Aspirin unless contraindicated
•Splenectomy
-1 unit phlebotomy removed weekly
-Can use hydroxurea for myeloproliferative problem
Patients suspected with polycythemia vera should always be referred to a? ✅✅CORRECT ANSW-
Hematologist
Lymphadenopathy (LAD) ✅✅CORRECT ANSW-Pathologic enlargement ensues when inflammation
or infiltration overtakes the node.
