Which sign is commonly seen in polycythemia vera due to increased red cell mass?

• A. Splenomegaly
• B. Pallor
• C. Bruising
• D. Cyanosis

Answer: (A)

Polycythemia vera features an increased red cell mass, which makes the blood thicker and more viscous. That heightened cellular activity often leads to the spleen enlarging as hematopoietic processes ramp up and red cells are sequestered and recycled, so splenomegaly is a common finding. Pallor would imply low red cell mass, not high, so it doesn’t fit. While bruising can occur in myeloproliferative disorders due to platelet dysfunction, it is not a direct consequence of the increased red cell mass. Cyanosis isn’t typical either, since the issue is excess red cells and viscosity rather than deoxygenation. Splenomegaly best reflects the impact of the increased red cell mass in polycythemia vera.