October 03, 2010

USMLE 1 Question 2

45 year old visits her physician because of respiratory complaints. After analyzing her blood work, she is told that she has a neutrophilic leukocytosis.

Which of the following is associated with neutrophilic leukocytosis?

a) hayfever
b) asthma
c) acute bacterial infection
d) ascaris
e) Loffler's Syndrome


The correct answer is C


A leukocytosis is an increase in the number of circulating leukocytes. A neutrophilic leukocytosis (neutrophilia) typically occurs in response to some sort of infection. All of the other conditions listed are associated with eosiniophilia.

Typically, acute bacterial infections are not associated with an eosinophilia.The most common causes of eosinophilia are allergic diseases and parasitic infections. The parasitic infections which are associated with eosinophilia involve invasion of the tissues. In addition, there are several other causes of eosinophilia.

The mnemonic for eosinophilia is 'worms, wheezes, and weird diseases'.

Hayfever and asthma both are due to a type I immune injury (IgE mediated), in which eosinophilia occurs. Ascaris is a parasitic tissue infection (non respiratory). 'Weird diseases' refers to a wide array of other conditions, including Hodgkin's disease, eosinophilic gastroenteritis, Loffler's syndrome and others (this is not an exhaustive list).

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