A65-Year-Old Man Is Brought to the ER Due to Recent

A65-year-old man is brought to the ER due to recent dyspnea on exertion and generalized fatigue. He has a history of recurrent heart failure exacerbations last year. He has hypertension, myocardial infarction and hypercholesteromia. he has a 30-pack-yaer smoking history in addition to 15-year history of alcohol abuse. Physical examination reveals tachycardia, distended neck veins, bilateral crackles on lung auscultation, a third heart sound on cardiac auscultation, and pedal edema.  The appropriate therapy is initiated. On the third day of hospitalization, his hematocrit level increases to 50%, up from 44% on admission. An arterial blood gas analysis shows an arterial O₂ partial pressure (PaO₂) of 70 mm Hg. A 51Cr-tagged red blood cell infusion indicates normal red blood cell mass. Which of the following is the most likely cause of this patient's polycythemia?

A) Polycythemia vera
B) Hypoxic erythrocytosis
C) Renal disease
D) Occult neoplasia
E) Relative erythrocytosis

Correct Answer:

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