Which of the following is a precipitating factor for a sickle cell crisis?

• A. Fluid overload
• B. Stress
• C. Insomnia
• D. Adherence to antibiotic treatment

Answer: (B)

Stress can trigger a sickle cell crisis because emotional or physical stress activates the sympathetic system, raising metabolic demands and often causing vasoconstriction and relative tissue hypoxia. This combination promotes deoxygenation of hemoglobin S, encouraging its polymerization, which makes red cells rigid and prone to clog small vessels, leading to a vaso-occlusive crisis. Dehydration, infection, and low oxygen levels are classic triggers, while fluid overload doesn’t directly promote sickling, insomnia isn’t a direct precipitant, and sticking with treatment for infections (antibiotics) helps prevent crises rather than precipitating them.