Neutrophilic leukocytosis, lymphoenia, and eosinopenia are most likely associated with which of the following disorders?
**Core Concept**
Neutrophilic leukocytosis, lymphopenia, and eosinopenia refer to a set of laboratory abnormalities characterized by an increase in neutrophil count, a decrease in lymphocyte count, and a decrease in eosinophil count. These findings are often associated with stress response, particularly in the context of critical illness or severe injury.
**Why the Correct Answer is Right**
These laboratory abnormalities are a manifestation of the body's stress response, mediated by the release of cortisol from the adrenal gland. Cortisol exerts its effects by binding to glucocorticoid receptors in various tissues, leading to the suppression of lymphocyte production and the redistribution of eosinophils. The resulting increase in neutrophil count is thought to be due to the mobilization of neutrophils from the bone marrow and the release of stored neutrophils from the spleen.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not accurately reflect the typical laboratory abnormalities associated with a stress response. While anemia may be present in critically ill patients, it is not a defining characteristic of the stress response.
**Option B:** This option is incorrect because it suggests a specific type of infection (sepsis) as the underlying cause, rather than the broader stress response.
**Option C:** This option is incorrect because it implies a specific type of disorder (inflammatory bowel disease) as the underlying cause, rather than the broader stress response.
**Clinical Pearl / High-Yield Fact**
The laboratory abnormalities associated with a stress response are often referred to as "Cushing's response" due to their similarity to the laboratory findings seen in patients with Cushing's syndrome. This response is a key concept in the differential diagnosis of critically ill patients.
**Correct Answer: C. Severe injury or critical illness.**