brainstem
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| carina
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17. (C) Polycythemia vera is a neoplastic disorder of my-
eloid stem cells that tend to differentiate predominantly
along the erythroid lineage, giving rise to polycythemia.
The neoplastic erythroid progenitor cells require extremely
small amounts of erythropoietin for survival and prolifera-
tion, and hence the levels of erythropoietin are virtually
undetectable in polycythemia vera. In all other conditions,
erythropoietin levels are elevated to produce excess red
cells. Erythropoietin secretion is triggered by anoxia in
high-altitude dwellers and persons with cyanotic heart dis-
ease. Renal tumors produce erythropoietin and trigger a
paraneoplastic erythrocytosis. In dehydration, transient
polycythemia is caused by hemoconcentration. This does
not affect normal erythropoietin secretion.
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