A 21-Year-Old Man Comes to the Office Due to Recent

A 21-year-old man comes to the office due to recent irritability and aggressive behavior.  He is a star college football linebacker and is training for his senior season.  The patient does not use tobacco or alcohol.  His mother has diabetes and his father has basal cell skin cancer.  Blood pressure is 132/84 mm Hg and pulse is 62/min.  The patient is muscular and well appearing.  There is no lymphadenopathy in the cervical or supraclavicular chains.  Cardiopulmonary examination is normal.  Mild gynecomastia is present.  The abdomen is soft and nontender.  Liver span is 8 cm, and the spleen is not palpable.  Laboratory results are as follows: Which of the following is the best single explanation for this patient's presentation?

A) Anabolic steroid abuse
B) Autologous blood transfusion
C) Erythropoietin abuse
D) Intensive exercise schedule
E) Polycythemia vera

Correct Answer:

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