MCQ Hematology Answer 28

The Correct Answer is E

Explanation:

Once a true RBC mass elevation has been documented, a search for a cause must ensue. The patient's history of nearly lifelong ruddy complexion could be due to tobacco abuse but may also suggest a congenital polycythemia.

Most congenital polycythemias are due to hemoglobin mutants with high oxygen affinity. These abnormal hemoglobin affinities as well as abnormal levels of 2,3-diphosphoglycerate (2,3-DPG) can be detected by measuring a P50 level on the oxygen saturation/desaturation curve.

Tumors and other disorders can lead to elevated levels of endogenous erythropoietin.

Arterial oxygen saturation and carbon monoxide determinations can rule out pulmonary and environmental conditions.

A bone marrow exam is rarely useful in the work-up of erythrocytosis, even for a potential diagnosis of polycythemia rubra vera, in which culture of erythroid progenitor cells for the detection of erythropoietin-independent colony growth is currently the closest thing to a diagnostic test for this disease.

Category: Hematology MCQs