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Pathophysiology of Polycythemia

- The pathophysiology of polycythemia involves an increase in red blood cell mass and viscosity, which leads to impaired blood flow and tissue oxygenation

- Relative polycythemia results from a decrease in plasma volume due to fluid loss or retention

- Secondary polycythemia results from an increase in EPO production due to hypoxia or tumors

- EPO stimulates the bone marrow to produce more red blood cells to compensate for the low oxygen levels

- Primary polycythemia results from a mutation in the JAK2 gene, which causes the red blood cell progenitors to proliferate independently of EPO stimulation

- The mutation also affects the platelet and white blood cell progenitors, causing thrombocytosis and leukocytosis

- The increased red blood cell mass and viscosity increase the risk of thrombosis, hemorrhage, ischemia, infarction, and organ damage

Questions on Pathophysiology of Polycythemia

Correct Answer is C

Explanation

Smoking can lead to secondary polycythemia, but it is not the cause of polycythemia vera, which is a primary disorder of the bone marrow.

Correct Answer is B

Explanation

Erythropoietin (EPO) actually stimulates the bone marrow to produce more red blood cells, not fewer. Therefore, this statement is incorrect.

Correct Answer is ["A","B"]

Explanation

Hypotension is not commonly associated with polycythemia. In fact, hypertension (high blood pressure) is more commonly seen as a result of increased blood viscosity and resistance to blood flow.

Correct Answer is B

Explanation

Obesity can lead to sleep apnea, which can cause secondary polycythemia due to chronic hypoxia during sleep. However, renal cysts are a more likely cause of secondary polycythemia than obesity alone.

Correct Answer is D

Explanation

<p>The increased red blood cell mass in primary polycythemia does lead to increased blood viscosity. The thicker blood can impede blood flow, leading to organ damage and ischemia (lack of blood supply to tissues) This is an accurate statement regarding the risks associated with primary polycythemia.</p>

Correct Answer is C

Explanation

Increased urination is not typically associated with polycythemia. This statement is not directly related to the condition and is less relevant.

Correct Answer is B

Explanation

"I've been coughing up blood." Rationale: Coughing up blood is not a typical symptom of polycythemia. It may be associated with other conditions or complications, but it is not a direct indication of polycythemia.

Correct Answer is ["A","C","D","E"]

Explanation

Gout. Rationale: Gout is a potential complication of polycythemia because the increased production of red blood cells can lead to elevated levels of uric acid, a risk factor for gout.

Low red blood cell count. Rationale: In primary polycythemia, the hallmark is an elevated red blood cell count, not a low count. The condition is characterized by the overproduction of red blood cells.

<p>Thyroid function tests are not typically used to rule out secondary polycythemia. Thyroid function tests assess the thyroid gland&#39;s hormone production and are unrelated to the primary causes of polycythemia.</p>

Shortness of breath can also be a symptom of polycythemia, especially when there is an excessive increase in red blood cells. However, like fatigue, it is not specific to polycythemia and can be caused by various respiratory and cardiac conditions.

Monitoring vital signs regularly is crucial for patients with polycythemia to detect any changes in blood pressure, heart rate, or oxygen saturation. This statement demonstrates an understanding of the importance of self-monitoring and is not a cause for further education.

Apply moisturizing lotion to dry skin. Rationale: This option is not a priority nursing intervention for a patient with polycythemia. While dry skin may be a symptom of the condition, it is not a primary concern compared to managing blood viscosity, clot risk, and oxygenation.

Perform phlebotomy to reduce hematocrit. Rationale: This is a correct statement and aligns with the primary goal of treatment for primary polycythemia. Phlebotomy is a key intervention to reduce hematocrit levels and, consequently, blood volume and viscosity.

<p>Perform phlebotomy to reduce hematocrit. Rationale: Phlebotomy may be considered in some cases of secondary polycythemia, but it is not the primary priority. The primary focus should be on addressing the underlying cause, such as treating COPD or renal disease, to manage polycythemia effectively.
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