Okay. Now, this is a medication
we give a lot of
in the hospital, out of the
hospital. We give a ton
Remember, corticosteroids are mimicking
what your body naturally makes
from your adrenal gland, the adrenal cortex.
That's why they're called corticosteroids.
That's what our adrenal gland normally
puts out, but we give corticosteroids
usually to suppress inflammation.
That's what we're looking for.
But the corticosteroids will modify
the leukocytosis response.
Okay, before we go on,
you already probably have some
ideas on why this happens.
Think about why would corticosteroids
modify leukocytosis response?
Well, you know that what are some
of the causes of leukocytosis?
Well, that means -- leukocytosis, that
means elevated white cell count.
What are the reasons that my white
cell count would be elevated?
Oh, that would be maybe because the body's
under attack for some type of infection,
but corticosteroids modify that.
Well, I give corticosteroids to
So what do you think?
What are corticosteroids going
to do to a white cell count?
Okay, let's see if your answer
lines up with ours.
Okay, so corticosteroids are meant
to suppress like the eosinophils,
the T-lymphocytes, the mast cells, the
macrophages, and the dendritic cells.
Those are the inflammatory
cells. And remember,
most often what we're looking
for with corticosteroids
is to suppress those cells, right?
We want to stop that inflammatory response.
So, if we give a corticosteroid
to a healthy person,
the white blood cell count will increase;
predominantly, the neutrophils.
But if we give a corticosteroid
to a person who has a severe infection,
here's what can happen.
Because the corticosteroid
suppresses the inflammatory cells,
you're going to see infection
that can spread
without us seeing an increase
in the white blood cells.
Okay, so let me back that up.
As healthcare professionals, we
monitor the white blood cells
as a sign of infection.
But if someone's on corticosteroids,
we're not going to see an increase
in those white cells
because the corticosteroids
suppressing those cells from responding.
So, meanwhile, that infection can be running
rampant throughout the patient's body,
and you won't see an elevation
in a white blood cell
that you would normally see
in a healthy person.
So keep that in mind. If you have a
patient who's on corticosteroids,
they might have a significant infection,
and we won't see a big impact in the
white cells because of that medication.
So we kind of like to say, think
of corticosteroids as
hiding an infection to the impact of
the white blood cell count not rising.
So, how corticosteroids impact someone
who might have a pretty severe infection
could be that we won't see the white
blood cell count respond or rise.
And so, in that way, infection is spreading,
but we don't see one of our normal signs,
as in the white blood cell count
won't rise with that.
Now let's look at polymorphonuclear
cells. We call them PMNs
because that is a mouthful,
So we call them PMNs or granulocytes.
So, polymorphonuclear cells
have multiple nuclei.
And with your permission, I
will now just call them
PMNs because that is, like
I said, quite a mouthful.
But now we're looking at the neutrophils,
the eosinophils, and the basophils.
Remember, they're PMNs because
they have multiple nuclei.
So these have multiple nuclei and
we're talking about 3 types:
neutrophils, eosinophils, and basophils.
So 3 of the 5 types of white blood
cells have multiple nuclei.
Now, we'll go back over the suffixes
again just to remind you.
"Philia" means -- it's from a Greek word --
means "philos" or true love.
So the meaning is someone or something that
loves or has a fondness or attraction to
or an affection for something.
You have a tendency towards something.
And related terms include -philic,
-philia, and -philo. Okay, so
these are the suffixes.
Now let's look at that second column; -penia.
That means low. That comes
from the Greek word
"penia" meaning poverty or need. So that
helps you remember that "penia,"
because it comes from poverty
or need, means low.
So, if we want to break it down more, it
means to lack or to have a deficiency.
It often indicates a specific
type of deficiency
when you add it to the end of the word.
So when you look at these 2 together,
we have -philia, which means love,
and of course you want more
of that, and -penia,
which means poverty; too low or not enough.