CHAPTER 4 Hematologic System^195
HALLMARK SIGNS AND SYMPTOMS
- Facial skin and mucous membranes dark and flushed (plethora)
- Hypertension due to increased peripheral vascular resistance and thickening
of the blood - Itching worse after warm shower due to histamine release from increased
basophils within dilated vessels - Headache and difficulty concentrating
- Vision blurred, tinnitus (ringing in ears), and hearing changes
- Thrombosis due to vascular stasis
- Spleen enlargement (splenomegaly)
- Tissue hypoxia and possible infarction of heart, spleen, kidneys, and brain
due to thrombosis
INTERPRETING TEST RESULTS
- Increased RBC count.
- Increased hemoglobin.
- Increased hematocrit level.
- Increased WBC count.
- Increased basophils.
- Increased eosinophils.
- Increased platelet count.
- Increased uric acid level.
- Increased potassium.
- Increased vitamin B 12 level.
- Bone marrow panhyperplasia; iron stores absent.
TREATMENT
Treatment is aimed at maintaining bloodflow to the smaller vessels and diminish-
ing the amount of excess blood cells being made by the bone marrow.
- Periodic scheduled phlebotomy—the removal of 500 ml of blood—to reduce
the hematocrit level to below 45; may be done weekly.