Erythrocytosis Flashcards

1
Q

What is erythrocytosis?

A

increased RBC and PCV/Hct

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2
Q

What is the difference between absolute and relative erythrocytosis?

A

ABSOLUTE - true increase in red cell mass (increased RBCs in circulation)

RELATIVE - RBC mass doesn’t increase in volume, but PCV and RBC count (hemoconcentration due to decreased fluid volume)

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3
Q

What’s the difference between primary and secondary absolute erythrocytosis?

A

PRIMARY - in the abscence of increased EPO (polycythemia vera)

SECONDARY - increased EPO activity

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4
Q

What care causes of appropriate and inappropriate secondary absolute erythrocytosis?

A

APPROPRIATE = decreased tissue oxygenation
- pulmonary disease
- R to L CV shunts
- heart failure
- high altitude
- hyperthyroidism

INAPPROPRIATE = normal tissue oxygenation
- hyperadrenocorticism
- renal masses that produce EPO
- neoplasm

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5
Q

What is the most common cause of relative erythrocytosis? What other bloodwork values are typically increased?

A

hemoconcentration caused by dehydration or splenic concentration

TS/TP

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6
Q

When are clinical signs seen with erythrocytosis? What are 7 signs?

A

> 70-80% PCV

  1. increased blood viscosity
  2. decreased perfusion to the CNS = acute neurologic abnormalities (depressed)
  3. spastic tetraparesis, seizures, ataxia, paraparesis, collapse
  4. behavioral changes
  5. PU/PD
  6. paroxysmal sneezing (polycythemia vera)
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7
Q

What is most commonly seen on physical exams in patients with erythrocytosis?

A
  • bright red MM
  • erythema
  • splenomegaly
  • renal masses
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8
Q

How can dehydration be ruled out as a cause of erythrocytosis?

A
  • high TP
  • (lack of) signs of dehydration of examination
  • response of PCV to flud therapy
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9
Q

What are the 3 most common secondary causes of erythrocytosis? How can it be diagnosed?

A
  1. respiratory disease - hypoxia (appropriate secondary)
  2. cardiac disease - hypoxia (appropriate secondary)
  3. renal masses - EPO production (inappropriate secondary)
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10
Q

How is primary erythrocytosis diagnosed?

A

(polycythemia vera)

  • bone marrow biopsy to look for neoplasia
  • EPO concentrations usually low or normal
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11
Q

What 2 treatments are recommended for primary erythrocytosis?

A
  1. therapeutic phlebotomy - removing RBCs and replaces with crystalloids to decrease blood viscosity
  2. hydroxyurea - chemotherapy stops bone marrow from producing RBCs
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