Hematologic Malignancies USMLE Step 1 Practice Question
A 58-year-old man presents with progressive headaches and intense pruritus following hot showers. Vital signs show BP 158/92 mmHg, HR 88/min, RR 16/min, temperature 37.2°C, and SpO2 98% on room air. Physical examination reveals facial plethora and splenomegaly. Laboratory studies demonstrate hemoglobin 18.5 g/dL, hematocrit 56%, erythropoietin level <2 mIU/mL, and normal arterial oxygen saturation. Chest radiograph shows no pulmonary disease. Which of the following is the most likely diagnosis?
Answer choices
- ARelative polycythemia due to dehydration
- BExogenous erythropoietin use
- CSecondary polycythemia due to chronic hypoxemia
- DEssential thrombocythemia
- EPolycythemia veraCorrect answer
- FSecondary polycythemia due to renal cell carcinoma
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