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Hello all,
I understand why the answer is right but I want to know the mechanism for the bolded part of the question.
Source of Question: Klatt EC, Kumar V. Robbins and Cotran Review of Pathology. 2nd edition, pg 265.
Chapter 20, Question 12:
A 32-year old man has developed a fever and rash over the past 3 days. Five days later, he has increasing malaise and visits his physician. On physical examination, the maculopapular erythematous rash on his trunk has nearly faded away. His temperature is 37.1c and blood pressure is 135/85 mm Hg. Laboratory studies show a serum creatinine level of 2.8 mg/dL and BUN level of 29 mg/dL. Urinalysis shows 2+ proteinuria, 1+ hematuria, and no glucose ketones, or nitrite. The leukocyte esterase result is positive. Microscopic examination of urine shows RBCs and WBCs, some of which are eosinophils. Which of the following is the most likely cause of this patient's condition?
(A) Urinary tract infection
(B) Congestive heart failure
(C) Antibiotic use (*answer)
(D) Streptococcal pharyngitis
(E) Poorly cooked ground beef
My question is what is the mechanism for the positive leukocyte esterase? I know that some leukocytes are attracted to the location but what brings them there? I know its a mixed type I and type IV hypersensitivity but what is the pathogenesis behind this and what is the differential breakdown (percentages) of the leukocytes? I know there is a prominent eosinophilia asscociated with this condition. So, yeah can anyone give a nice explanation of the mechanism for this as Robbins pathologic basis of disease 8th edition and Goljan's rapid review were not very helpful. Thank you guys and good luck with step 1 for all who are prepping.
Take care.
I understand why the answer is right but I want to know the mechanism for the bolded part of the question.
Source of Question: Klatt EC, Kumar V. Robbins and Cotran Review of Pathology. 2nd edition, pg 265.
Chapter 20, Question 12:
A 32-year old man has developed a fever and rash over the past 3 days. Five days later, he has increasing malaise and visits his physician. On physical examination, the maculopapular erythematous rash on his trunk has nearly faded away. His temperature is 37.1c and blood pressure is 135/85 mm Hg. Laboratory studies show a serum creatinine level of 2.8 mg/dL and BUN level of 29 mg/dL. Urinalysis shows 2+ proteinuria, 1+ hematuria, and no glucose ketones, or nitrite. The leukocyte esterase result is positive. Microscopic examination of urine shows RBCs and WBCs, some of which are eosinophils. Which of the following is the most likely cause of this patient's condition?
(A) Urinary tract infection
(B) Congestive heart failure
(C) Antibiotic use (*answer)
(D) Streptococcal pharyngitis
(E) Poorly cooked ground beef
My question is what is the mechanism for the positive leukocyte esterase? I know that some leukocytes are attracted to the location but what brings them there? I know its a mixed type I and type IV hypersensitivity but what is the pathogenesis behind this and what is the differential breakdown (percentages) of the leukocytes? I know there is a prominent eosinophilia asscociated with this condition. So, yeah can anyone give a nice explanation of the mechanism for this as Robbins pathologic basis of disease 8th edition and Goljan's rapid review were not very helpful. Thank you guys and good luck with step 1 for all who are prepping.
Take care.
