What's the clue in this Q?

[BlackNDecker]

A 23 year-old woman has noticed that she develops a skin rash if she spends prolonged periods outdoors. She has a malar rash on physical examination. Laboratory studies include a positive ANA test result with a titer of 1:1024 and a "rim" pattern. An anti-double stranded DNA test is also positive. The hemoglobin concentration is 12.1 g/dL, hematocrit 35.5%, platelet count 109,000/mm3, and WBC 4500/mm3. Which of the following findings is most likely to be demonstrated by a WBC differential count?

A. Eosinophilia
B. Lymphocytosis
C. Monocytosis
D. Neutrophilia
E. Basophilia

Anyone wanna explain why the answer is Monocytosis and not Lymphocytosis?

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[BlackNDecker]

Sorry, nevermind....

 

[dr_siba21]

A 23 year-old woman has noticed that she develops a skin rash if she spends prolonged periods outdoors. She has a malar rash on physical examination. Laboratory studies include a positive ANA test result with a titer of 1:1024 and a "rim" pattern. An anti-double stranded DNA test is also positive. The hemoglobin concentration is 12.1 g/dL, hematocrit 35.5%, platelet count 109,000/mm3, and WBC 4500/mm3. Which of the following findings is most likely to be demonstrated by a WBC differential count?

A. Eosinophilia
B. Lymphocytosis
C. Monocytosis
D. Neutrophilia
E. Basophilia

Anyone wanna explain why the answer is Monocytosis and not Lymphocytosis?

isnt it SLE

monocytes are very less in differential count (0 to 1%) . so its increase will not bring any remarkable increase in the TWBC . but increase in any other will cause a noteworthy increase in the differential count i.e. more than 4500/mm3 .

 

[ANGII]

i think that the answer is Lymphocytosis .....
what we have here is an auto-immune disorder and as you know all the trouble is caused by drunk lumphocytes who produce nasty immunoglobulins !!
and it's not monocytosis coz it generally does not come in the package of immune disorders

 

[BlackNDecker]

i think that the answer is Lymphocytosis .....
what we have here is an auto-immune disorder and as you know all the trouble is caused by drunk lumphocytes who produce nasty immunoglobulins !!
and it's not monocytosis coz it generally does not come in the package of immune disorders

Nope...think about it. When do you find macrophages? CHRONIC INFLAMMATION. SLE is basically a disease of chronic inflammation. True, there is polyclonal B cell activation, but the # is not substantially increased. Furthermore, according to Robbins the polyclonally activated B cells aren't even the ones implicated in the immunopathology!

monocytes are very less in differential count (0 to 1%) . so its increase will not bring any remarkable increase in the TWBC . but increase in any other will cause a noteworthy increase in the differential count i.e. more than 4500/mm3 .

Absolutely right, and very well put...