Prep4USMLE Forum » USMLE Step 1 Forum » Pathology Forum |   uw q....help

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mikky Forum Elite Topics: 15 Posts: 284	10/30/07 - 11:17 AM             #1 a 53 year old woman admitted to hospital with cardiac failure.on third day of her admission hct is 50%.arterial blood gas analysis shows PaO2 of 70mm hg.a 51 cr-tagged red blood cell infusion shows normal rbc mass.which of the following is most likely cause of her polycythemia? 1)polycythemia vera rubra 2)hypoxic erythrocytosis 3)renal disease 4)occult neoplassia 5)relative erythrocytosis ___________________ srama nee ayutham aithe vijayam nee banisa avuthundi
mikky Forum Elite Topics: 15 Posts: 284	10/30/07 - 11:21 AM             #2 the answer given was 5... explanation normal rbc mass... the explanation also says that if PaO2 is less than 92% hypoxic encephalopathy should be considered.....so the answer 5 or 2??????? ___________________ srama nee ayutham aithe vijayam nee banisa avuthundi
SmokyWaters Forum Elite Topics: 6 Posts: 458	10/30/07 - 11:54 AM             #3 its relative erythrocytosis
SmokyWaters Forum Elite Topics: 6 Posts: 458	10/30/07 - 11:56 AM             #4 oh I am sorry... I just read your second post hypoxic encephalopathy :S oh okie u mean to say hypoxic erythrocytosis... yes you should consider this but when there is HYPOXIC erythrocytosis ...then there is goin to be INCREASED RED CELL MASS... relative is when there is no increase in red cell mass as confirmed by the radionuclide tag
SmokyWaters Forum Elite Topics: 6 Posts: 458	10/30/07 - 11:59 AM             #5 let me explain it a bit more... when there is hypoxia...the HIF 1 (hypoxia induced factor) is activated in peritubular capillary endothelium in adults causing increase Epo production...this increases all the cell stages of RBC...which increases TOTAL HEMOGLOBIN and TOTAL RBC MASS... RBC mass is measured by chromium tag... which is normal...if its normal...then usually dehydration or loss of plasma is the cause .... in post op period...there is increased loss of fluid and dehydration due to pain or any other reason... which causes relative erythrocytosis..that is what has happened here... hope u can understand my latin..am really bad at explaining things
SmokyWaters Forum Elite Topics: 6 Posts: 458	10/30/07 - 12:02 PM             #6 1)polycythemia vera rubra ...increased RBC mass...increase plasma vol...normal 100mmHg usually...with all lineages of myeloid cell increased obviously HIGH HCt... 2)hypoxic erythrocytosis ...increase RBC count..mass and EPo 3)renal disease ....increased RBCcount ..mass...EPo in case of cyst/RCC... 4)occult neoplassia ... duh! 5)relative erythrocytosis .... given the explanation already
mikky Forum Elite Topics: 15 Posts: 284	10/31/07 - 01:48 AM             #7 yeah... it`s hypoxic erythrocytosis.... thanx 4 explanation ___________________ srama nee ayutham aithe vijayam nee banisa avuthundi

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