Knowledge Check
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Sort the tests (top) according to whether they should be ordered as first-line tests in all patients with polycythemia, as second line tests according to symptoms, or not at all (bottom):
Serum ferritin
Echocardiogram
TSH
Serum EPO
Reticulocyte count
Abdominal/pelvic imaging
Sleep study
CXR
SaO2
CBC
Cardiac troponin
Liver function
ANA
Jak2 mutation (if PV suspected)
Neuro imaging
Renal function
Liver biopsy
First-line tests
Second-line tests
Not indicated
Abbreviations: CBC, complete blood count; SaO2, arterial oxygen saturation; EPO, erythropoietin; CXR, chest X ray; TSH, thyroid stimulating hormone; ANA, antinuclear antibody.
True of false: in the primary care setting, where the probability of PV is low, clinical evaluation for secondary causes of erythrocytosis paired with a high erythropoietin level can rule out PV in most patients.
a
True
b
False
In a young patient with a family history of erythrocytosis in whom first line and second lines studies do not reveal a diagnosis, what 2 tests would you consider:
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