A 52-year-old woman comes to the physician complaining of episodes of blurry vision and headaches. She has severe itching after showering. her medical history is unremarkable. She has one daughter who was diagnosed with multiple sclerosis at age 23. Her temperature is 36.7°C (98.1°F), pulse is 80/min, and blood pressure is 144/84 mm Hg. Examination shows facial erythema. There are mild scratch marks on her arms and torso. Left hand strength is slightly decreased and there is mild dysmetria of the left hand on finger-to-nose testing. The remainder of the neurological examination shows no abnormalities. Her laboratory studies show Which of the following is the most likely cause of this patient's findings?

Question

A 52-year-old woman comes to the physician complaining of episodes of blurry vision and headaches. She has severe itching after showering.  her medical history is unremarkable. She has one daughter who was diagnosed with multiple sclerosis at age 23. Her temperature is 36.7°C (98.1°F), pulse is 80/min, and blood pressure is 144/84 mm Hg. Examination shows facial erythema. There are mild scratch marks on her arms and torso. Left hand strength is slightly decreased and there is mild dysmetria of the left hand on finger-to-nose testing. The remainder of the neurological examination shows no abnormalities. Her laboratory studies show  Which of the following is the most likely cause of this patient's findings?

Quizplus · Accepted Answer

Eductional Objective: Polycythemia vera (PV) is a clonal myeloproliferative disease characterize by an increased RBC mass, increased plasma volume, and low erythropoietin levels.  PV can be differentiated from secondary polycythemia by the presence of leukocytosis, thrombocytosis, and/or splenomegaly.  The majority of patients with PV have a JAK2 mutation rendering hematopoietic stem cells more sensitive to growth factors.

A 52-Year-Old Woman Comes to the Physician Complaining of Episodes