Haematology: polycythaemia vera: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Haematology: polycythaemia vera

Sample item

A 58-year-old has facial plethora, pruritus after a hot bath and splenomegaly with Hb 19 g/dL. Which test result is expected and supports primary rather than secondary erythrocytosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Low serum erythropoietin with JAK2 mutation

Polycythaemia vera has a JAK2 mutation causing independent red cell production, so erythropoietin is suppressed. Secondary polycythaemia shows high erythropoietin.

Option by option

  • A. High serum erythropoietin with normal arterial oxygen

    High erythropoietin with normal oxygen suggests an erythropoietin-secreting tumour such as renal cell carcinoma.

  • B. Normal erythropoietin with BCR-ABL1

    BCR-ABL1 defines CML and not polycythaemia vera.

  • C. High serum erythropoietin with low arterial oxygen

    High erythropoietin with low oxygen is secondary to hypoxia, as in lung disease.

  • D. Low serum erythropoietin with JAK2 mutation (correct)

    Correct. Suppressed erythropoietin with JAK2 positivity indicates primary disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Low serum erythropoietin with JAK2 mutation. Polycythaemia vera has a JAK2 mutation causing independent red cell production, so erythropoietin is suppressed.

Why is "High serum erythropoietin with normal arterial oxygen" not the answer?

High erythropoietin with normal oxygen suggests an erythropoietin-secreting tumour such as renal cell carcinoma.

Why is "Normal erythropoietin with BCR-ABL1" not the answer?

BCR-ABL1 defines CML and not polycythaemia vera.

Why is "High serum erythropoietin with low arterial oxygen" not the answer?

High erythropoietin with low oxygen is secondary to hypoxia, as in lung disease.

What concept does this question test?

It tests Haematology: polycythaemia vera in Pathology. Secondary polycythaemia shows high erythropoietin.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology: polycythaemia vera?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.