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A 65 year old woman presents with headache. Segaly, itchy after hot bath. Laboratory: RBC 87, Hgb 31.9, Plt 796. What is t

waelhammad
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2022-10-31
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A 65 year old woman presents with headache. She also complains of dizziness and tinnitus. She has recently realized she has visual problems. There is history of burning sensation in fingers and toes. On examination: splenomegaly, itchy after hot bath. Laboratory: RBC 87, Hgb 31.9, Plt 796. What is the diagnosis?

  1. CML
  2. CLL
  3. Polycythemia vera
  4. Myelofibrosis
  5. NHL
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waelhammad
2022-10-31
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The key is C. Polycythemia vera. [Points in favour: i) hyperviscosity symptoms (headache, dizziness, tinnitus, visual problem) ii) pruritus, typically after a hot bath, iii)splenomegaly iv) RBC 87, Hb 31.9, Plt 796].

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