Choice A rationale:

While primary polycythemia can cause an increase in red blood cell mass, it does not typically lead to decreased platelet production.

Platelet production is not directly affected by primary polycythemia.

Choice B rationale:

Primary polycythemia does increase red blood cell mass, but it also increases the risk of thrombosis (clot formation) due to the increased viscosity of the blood.

This statement is inaccurate.

Choice C rationale:

Primary polycythemia can affect white blood cell production, leading to an increase in white blood cells (leukocytosis)

This statement is inaccurate as well.

Choice D rationale:

The increased red blood cell mass in primary polycythemia does lead to increased blood viscosity.

The thicker blood can impede blood flow, leading to organ damage and ischemia (lack of blood supply to tissues)

This is an accurate statement regarding the risks associated with primary polycythemia.