A burn patient will have ____________ polycythemia due to loss of plasma volume

• A. Primary
• B. Secondary
• C. Polycythemia Vera
• D. Relative

Answer: (B)

Major fluid shifts after a burn cause plasma volume to drop as capillary leak occurs. Because the red cell mass remains the same while plasma volume decreases, the blood appears more concentrated—hematocrit rises without an actual increase in red cell production. This is relative polycythemia. Primary polycythemia vera is an intrinsic overproduction of red cells, while secondary polycythemia involves a true increase in red cell mass driven by elevated erythropoietin in response to hypoxia or other stimuli. So in the burn scenario, the polycythemia is best described as relative due to plasma-volume loss.