12/4/2016

BMJ OnExamination Assessment : REF64695 : REF64695

Work Hard - MRCP Part 2 Written

Exam Options

Work hard progresses you systematically through the case problems giving you questions from all topics relevant to the current exam

in a random pattern; this encourages you to answer as many questions as possible, testing your knowledge on multiple topics.

1938/ 1956 questions answered

Question 1938 of 1956

A 33-year-old man presents with headaches, blurring of vision and a Haemoglobin of 210 g/L and a Haematocrit of 0.62.
The white cell and platelet counts are normal and there are no diagnostic features on the blood lm. He is a non-smoker.
What is the next most important step?
(Please select 1 option)
Check erythropoietin levels
Organise for a renal ultrasound and a chest x ray
Perform Jak2 mutation status

Incorrect answer selected

Plasmapheresis
Venesection

This is the correct answer

Venesection of patients who are symptomatic is the rst line management of polycythaemia.
The diagnostic workup and exclusion of secondary causes usually follows after initial treatment. This patient has symptoms of hyperviscosity and needs
to be venesected urgently and anagreed work-up can be performed later.
This patient is at risk of thrombosis due to hyperviscosity and needs treatment urgently.

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Score: 59.94%
Total Answered: 317

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