Polycythemia

RBC disorders

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Polycythemia by Mind Map: Polycythemia

1. Secondary Polycythemia

1.1. Hypoxia driven: lack of O2 stimulates RBC production

1.1.1. high EPO levels, kidney secretes this cytokine in response to hypoxia

1.1.2. high altitude

1.1.3. cardiopulmonary disease

1.1.4. Defective O2 transport

1.2. Hypoxia independent

1.2.1. Cancer or benign tumors make EPO

2. Primary Polycythemia(polycythemia vera)

2.1. Polycythemia Vera- caused by mutation in the JAK2 gene.

2.2. Manifestations r/t hypertension caused by hypervolemia and hyperviscosity

2.2.1. Blood vessel distention, impaired blood flow, circulatory stasis, thrombosis, and tissue hypoxia from the hypervolemia and hyperviscosity. These then lead to...

2.2.2. Manifestations: Headache, dizziness, tinnitus, and visual changes. Generalized Pruritis r/t histamine release from excess basophils, Paresthesia and erythromelalgia(burning sensation of hands and feet). angina, HF, intermittent claudication, thrombophlebitis, which may be complicated by embolization.

2.2.2.1. Complications: Hemorrhagic problems caused by overdistention or inadequate platelet function

2.2.2.2. Petechiae, bruising, nosebleeds, or GI bleeding.

2.2.2.3. Hepatomegaly or splenomegaly from organ engorgement

2.2.2.4. RBC destruction leads to increased uric acid production which leads to hyperuricemia and gout

2.3. Increased production of RBCs, WBCs, and platelets

3. Diagnostic Studies

3.1. High hemoglobin and RBC count with microcytosis

3.2. Low to normal EPO level(secondary has high level)

3.3. high WBC count with basophilia and neutrophilia

3.4. high platelet count and platelet dysfunction

3.5. high leukocyte alkaline phosphatase, uric acid, and cobalamin levels

3.6. high histamine levels