Final answer:
The student's symptoms suggest a working diagnosis of Polycythemia vera (PV), a rare blood disorder characterized by overproduction of red blood cells. Spider nevi, or red streaks on the skin, are commonly seen in PV patients. The next step would involve confirming the diagnosis through blood tests and managing the condition through medication and lifestyle changes.
Step-by-step explanation:
The student's symptoms, including a smoking history, hypertension, hematuria, and a ruddy appearance, suggest a working diagnosis of Polycythemia vera (PV). PV is a rare blood disorder characterized by the overproduction of red blood cells, leading to an increased risk of blood clots and related complications.
The red streaks seen on the patient's skin are known as spider nevi, which are commonly seen in PV patients. They occur due to the dilation of small blood vessels near the skin's surface.
The next step in managing this condition would involve confirming the diagnosis through blood tests, such as a complete blood count and genetic testing. Treatment for PV typically involves medications to reduce the production of red blood cells, as well as managing underlying conditions like hypertension and smoking cessation.