Final answer:
The older patient's symptoms and high hematocrit level suggest a myeloproliferative neoplasm. A bone marrow biopsy is the best first test to confirm the condition. Treatment options include managing symptoms, avoiding triggers, and reducing red blood cell production if needed.
Step-by-step explanation:
The symptoms described by the older patient suggest a condition called myeloproliferative neoplasm, which is characterized by generalized pruritus and flushing after a hot bath. The high hematocrit level of 60% further supports this diagnosis, as it indicates an abnormal increase in red blood cell production. The best first test to confirm this condition is a bone marrow biopsy, which can reveal the presence of abnormal cells.
Treatment for myeloproliferative neoplasms generally focuses on managing symptoms and reducing the risk of complications. This may include medication to control itching, antihistamines, and avoiding triggers like hot baths. In more severe cases, therapeutic phlebotomy or medication to reduce red blood cell production may be necessary.