another q - drgoljan

[ArchivalUser]

A patient with mild congestive heart failure is treated with high-dose
furosemide and diureses 25 pounds of fluid. A complete blood count (CBC)
taken before the diuresis shows an RBC count of 4 million/mm3; a CBC
taken after diuresis shows a RBC count of 7 million/mm3. Which of the
following is the most likely explanation?
A. Cyanotic heart disease
B. Increased erythropoietin
C. Polycythemia vera
D. Relative polycythemia
E. Renal cell carcinoma

[ArchivalUser]

DDDD

[ArchivalUser]

ddd due to hemoconcentration

[ArchivalUser]

ddd

[ArchivalUser]

D is right example of relative polycythemia, in which there is an increased hematocrit or RBC count without a true increase in the total number of body RBCs. What usually happens in these cases is a significant reduction in plasma volume due to processes such as dehydration, vomiting, diarrhea, or diuresis.
Cyanotic heart disease (choice A), via appropriate erythropoietin secretion, can cause secondary absolute polycythemia.
Increased erythropoietin (choice B), whether appropriately or inappropriately secreted, can cause secondary absolute polycythemia.
Polycythemia vera (choice C) causes primary absolute polycythemia with usually low erythropoietin levels.
Renal cell carcinoma (choice E), via inappropriate erythropoietin secretion, can cause secondary absolute polycythemia.

[ArchivalUser]

dddddddd