Rosh Emergency Medicine Practice Test

Which condition is likely responsible for elevated hematocrit levels in a patient with a history of smoking and increased urination?

1. Alcohol use disorder

2. COPD

3. Migraine headache

4. Osteoarthritis

The correct answer is: COPD

Elevated hematocrit levels indicate an increased concentration of red blood cells in the blood, which can occur due to a variety of factors. In patients with a history of smoking, Chronic Obstructive Pulmonary Disease (COPD) is a significant consideration. Smoking is a major risk factor for COPD, which leads to impaired lung function and chronic hypoxia. As the body experiences decreased oxygenation, it responds by producing more red blood cells to enhance oxygen transport, resulting in an elevated hematocrit. Additionally, increased urination could be a byproduct of the body's response to chronic respiratory conditions, which may impact kidney function or fluid balance. In the context of COPD, the body often requires more red blood cells due to chronic low levels of oxygen, necessitating an adjustment in hematocrit levels. This physiological response to hypoxia makes COPD the most plausible explanation for elevated hematocrit in this scenario, particularly given the patient's smoking history. Understanding the connection between chronic lung diseases and alterations in blood parameters is crucial when interpreting clinical conditions.