Hematology and Oncology Part 3 Hematologic Neopla: 1 6 Conditions (SU2 p141 ~ SU2 p143) What is the classic presentation of polycythemia vera? Most signs and symptoms are related to hyperviscosity causing vascular sludging. + Average age of onset 50-60 years (but children and young adults can be affected as well) + Visual disturbances — blurred vision, amaurosis fugax, scintillatirg scotoma, ophthalmic migraine . __. (15%) ~ stroke, MI or angina, claudication, DVT or PE, Budd-Chiari syndrome, ‘superficial thrombophiobitis + Erythromelalgia — with erythema, pallor, or cyanosis . (esp. after a warm bath) + elevated H&H and red cell mass, basophilia, leukocytosis (40%), thrombocytosis (60%) ‘What is the treatment for polycythemia vera? + Phlebotomy to keep hematocrit below 45% in men, 42% in woman. = _ Induces a desirable iron deficiency anemia -> do not supplenent iront + Add if at high-risk for thrombosis (over age 70, prior thrombosis, platelets > 1,500,000, or presence of cardiovascular risk factors) : {qd to help prevent thrombosis (MI, CVA, PE, DVT) + Ifrefractory pruriis or refractory erythrocytosis, -> + if symptomatic hyperuricemia, -> allopurinol 300mg ad Step 2—Heme/One Copyright © 2011, Doctors InTraining.com, LLC, Al Rights Reserved