NBME-form2-block1#31 - doubleblessing

[ArchivalUser]

Alveolitis with interstitial edema, inflammatory cell accumulation, and type II epithelial cell hypertrophy and hyperplasia is believed to be an early and central event of pathogenesis of
a. anthracosis
b. asthma
c. centriacinar emphysema
d. chronic bronchitis
e. pulmonary firbosis

[ArchivalUser]

it is e i read it somewhere these are the early findings of pul fibrosis

[ArchivalUser]

I agree with e. pulmonary fibrosis.
But this is a tricky question...

[ArchivalUser]

E is the best choice becuase by defenition emphysema is the destruction of the alveolar septa(so the gross picture will be dialation of the alveoli),whatever the primary cause is.The question stem do not carry such an information.simple alveolitis cannot be taken as emphysema if it does not destroy septal wall.

Idiopathic pulmonary fibrosis is a group of poorly understood pulmonary disorders characterized histologically by diffuse interstitial inflammation and fibrosis.In early cases microscopy of lung shows pulmonary edema,intraalveolar exudation,hyaline membranes,infiltration of alveolar septa with mononuclear cells,hyperplasia of type2 pnuemocytes.

with advancing disease there is organization of intraalveolar exudate by fibrous tissue as well as thickening of interstitial septa due to fibrosis.

causes-in half of the cases it is idiopathic.Rest-pneumoconiosis,hypersensitivity pneumonitis,oxygen toxicity,scleroderma,irradiation injury.

[ArchivalUser]

thanks for the explanation