nbme1__________________Q - dep

[ArchivalUser]

A homeless 38-year-old man has a 30month history of decreased appetite, generalized wasting, a low-grade fever, and worsening cough productive of bloody, mucopurulent sputum. He has a 3-year history of alcohol abuse. X-ray films of the chest show consolidation and cavitary lesions in the apices of the lungs. Which of the following is the most likely inflammatory and/or immune response in the lung?
A) Endothelial cell proliferation, vascular budding, fibroblasts
B ) Epithelioid cells, multinucleated giant cells, caseation necrosis
C ) Fibroblasts, collage deposition, replacement of intrinsic tissue
D ) Macrophages, lymphocyts, hypergammaglobulinemia
E ) Neutrophils, vascular congestion. Exudates

[ArchivalUser]

b) TB

-the duration
-dec appetite and wasting
-bloody sputum
-consolidation+cavitary lesions
-apical concentration of lesions

[ArchivalUser]

Klabsella also causes cavitary lesion in apical region and comon in ALCOHOLICS and causes bloody sputum correct me if i m wrong


From goljan lectures
causes of cavitation
1.T.B
2.klabsella
3.sq cell ca of lung
4.histoplasma




so if it is klabsella then ans would be E?

[ArchivalUser]

yes dep, then i guess that would be E, and yeah bloody sputum, apical predilection is right for Klebsiella. The only reason i chose TB was the time period.

[ArchivalUser]

but in ans key ans is B

[ArchivalUser]

dep ,
it s not acute case---so surely we can eliminate ans EE(neutrophilis)

[ArchivalUser]

yeah, thats what i said dep... choose B over the next best E

[ArchivalUser]

oh yeah 30 month long history
so it should be t.b
thank u so muchhhhhhhhh drbkc and samo

[ArchivalUser]

for me is B, anyowhere where i see that kind of description is TB cause is the mcc, but also u can think about Ca of lung, but first TB pulmonar!!

[ArchivalUser]

all the bessssssssst dep