00:01
So let's go through this one
more time with leukocytosis.
00:04
That's a white cell count above 10,000.
00:07
Well, "leuko" means white cell,
"cytosis" means extra, right?
So we know that normal for
an adult is 5,000-10,000,
or you may hear us say "5-10,"
and it's usually due to an increase in one
of the 5 types of white blood cells.
00:23
Now that's really important.
00:25
When I have an elevated white
cell count above 10,000,
it's usually due to an increase
in one of the 5 types.
00:34
Now, just for fun, see if you can remember
how many of the 5 types
you can name without looking at your notes.
00:40
Okay, try and write them in
your margin real quick.
00:47
Okay, no cheating. We need you
to really work on that with me
because that's going to help your
brain remember and recall things.
00:55
So we've got leukocytosis, a white
cell count above 10,000,
because we know that's the top of
the normal range for an adult.
01:01
It's usually due to an increase of one
of the 5 types of white blood cells.
01:07
Now, we give it the name of the
cell that shows the primary increase.
01:11
I know that sounds a little tricky right
now, but it's really straightforward.
01:14
Let me make this clear.
01:17
If I have the neutrophils elevated,
I have neutrophilic leukocytosis.
01:23
We already know that leukocytosis
means extra white cells,
but this is telling me neutrophilic
leukocytosis,
so the one type of white cell that's
elevated, are the neutrophils.
01:34
Now, it follows the same pattern
all the way through.
01:37
Lymphocytic leukocytosis is lymphocytosis.
01:41
That means I have extra of the lymphocytes.
01:45
Eosinophilic leukocytosis is eosinophilia.
01:49
Now, that's a number you should
try out on your family.
01:52
Just walk by and if they ask you what
you've been studying, say,
"Well, you know, I've been looking
at eosinophilic leukocytosis."
Just see what they think. It's kind of fun to
impress them with those big words.
02:01
Monocytic leukocytosis is monocytosis.
02:06
And last of the 5, basophilic
leukocytosis is basophilia.
02:11
Okay, those are some pretty big words,
but it's most important that you understand,
they identify which one of the 5 types
of white blood cells are elevated.
02:23
Let's look at what happens when the
white blood cells respond to an attack,
because white blood cells release
the colony stimulating factor.
02:31
Now we've called that CSF. That's
not cerebral spinal fluid.
02:35
We're talking about colony
stimulating factor.
02:39
So you see our 5 types of
white blood cells there.
02:42
Now the body is under attack, so
the white blood cells will release
colony stimulating factor. Now its
job will tell the bone marrow,
"Hey, guys, pick it up. We need you to increase
the white blood cell production."
So your body's attacked.
02:57
The white blood cells release
colony stimulus factor.
03:01
The colony stimulating factor
tells the bone marrow
to increase the white cell production.
03:06
Now, here's the cool part. Look at this.
03:10
The normal bone marrow can double the
white blood cell count within hours.
03:15
Okay, that is phenomenal. Stop and
think about that for just a minute.
03:20
Within just a few hours, you can completely
double a normal white blood cell count
in response to infection.
03:27
That's why our immune system can
fight off some pretty big bugs
if it's healthy and functioning the
way it was intended to.
03:36
So, leukocytosis. Remember we said
it's usually not increased in
all 5 types of white blood cells.
03:41
If you notice that all 5 of
them are increased,
consider dehydration and hemoconcentration.
03:48
When a patient is pretty
significantly dehydrated,
their blood becomes super concentrated,
and that's an indication when all 5 of
the white blood cells are elevated.
03:59
So you're going to want to look at their fluid
volume status. You'll look at their sodium.
04:02
Kind of get a feel for if we think they're
intra-vascularly dehydrated.
04:07
That could be a sign if all 5 types of
the white blood cells are elevated.
04:11
Now, also with a dramatic white blood
cell increase, you might think about
measles, pertussis, or sepsis.
04:19
These will be temporary increases in
a dramatic white blood cell increase.
04:24
But you have this dramatic increase. It might
also be something similar to leukemia,
which would be more permanent
and progressive.
04:31
So, if I have all 5 types of white blood
cells elevated, I'm thinking,
"Huh, is my patient dehydrated and
therefore hemoconcentrated?"
Otherwise, if I have a dramatic
white blood cell increase,
I want to think about measles,
pertussis and sepsis,
or there may be something
like leukemia that's going on.