MCQ Hematology Answer 31

The Correct Answer is E


Explanation:

Recognize that this patient has all of the manifestations of polycythemia rubra vera except that his bleeding gastric ulcer has masked the development of polycythemia. Because of his bleeding gastric ulcer, he has already become iron deficient, which is the goal of the cornerstone phlebotomy therapy for polycythemia vera.

Instituting iron supplementation at this point may very well give the patient more morbidity because it could cause a rebound erythrocytosis.

Rather, the H. pylori infection should be treated to cure the gastric ulcer, and a further work-up for a probable diagnosis of polycythemia vera should ensue, including culture of the patient's erythroid progenitor cells looking for EPO-independent colony growth, a hallmark for the diagnosis of polycythemia vera.

Category: Hematology MCQs