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Medicine Endocrinology 74f42457

Neutrophilic leukocytosis, lymphopenia, and eosinopenia are most likely associated with which of the following disorders?

A
Endotoxic shock
B
Typhoid fever
C
Whooping cough
D
Cushing syndrome
High-Yield Explanation
Neutrophilic leukocytosis, lymphopenia, and eosinopenia are most likely associated with Cushing syndrome and the hypercoisolism associated with the syndrome. Coisol decreases neutrophil adhesion in the peripheral blood, thus releasing the marginating pool into the circulation. Coisol also increases lymphocyte adhesion in the efferent lymphatics and is toxic to eosinophils. Endotoxic shock results in a neutropenia because endotoxins increase neutrophil adhesion. Absolute neutropenia is a feature of typhoid fever, splenomegaly, and sinus bradycardia. Whooping cough due to Bordetella peussis produces an absolute lymphocytosis. Paroxysmal nocturnal hemoglobinuria, an acquired stem-cell disorder with increased sensitivity of hematopoietic cells to complement destruction, is associated with aplastic anemia and pancytopenia. Ref - Harrison's principles of internal medicine 20e pg 2680-2681, 2681t, 2724-2725

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