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Polycythemia vera — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Polycythemia veraUSMLE Step 3

A 74-year-old man has chronic fatigue, pruritus after hot showers, headaches, and blurred vision. Hemoglobin is 19.2 g/dL, hematocrit is 58%, leukocytes and platelets are mildly elevated, and oxygen saturation is 97%. Which of the following is the most likely diagnosis?

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Correct answer: B — Polycythemia vera

Elevated red cell mass with leukocytosis, thrombocytosis, aquagenic pruritus, and normal oxygen saturation suggests polycythemia vera.

Reference: NCCN myeloproliferative neoplasm guidance; USMLE Step 3 Content Outline