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| Nonmalignant Disorders of Leukocytes | ||
Question #1 You are asked to consult on a case involving a 26-year-old man who developed leukocytosis after a motorcycle accident 3 days ago. The patient has multiple fractures of the pelvis and lower extremities, extensive soft-tissue injury, and aspiration pneumonia. His leukocyte count was 35,000 on admission and has subsequently ranged up to 50,000. Currently, the patient is sedated and is on a ventilator. He is being treated with I.V. antibiotics. Physical examination is remarkable for right lower lateral consolidation, ecchymoses of the lower extremities, and the absence of hepatosplenomegaly... Laboratory values are as follows: hemoglobin, 9.5 g/dl; platelets, 140,000/mm33, with 95% neutrophils and bands. No myelocytes or metamyelocytes are noted, and there is no elevation of the basophil or eosinophil count. The leukocyte alkaline phosphatase (LAP) score is 140 µm/L.Which of the following cannot be the cause of this patient's elevated neutrophil count? Please choose the single most appropriate answer to the question. | ||