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  #1  
Old 07-31-2011
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I agree cxr

A 48-year-old nonsmoking woman has experienced shortness of breath, fever and weight loss for 5 months. On auscultation, fine rales are heard across all lung fields. A CXR shows hilar lymphadenopathy and small, reticulonodular densities in all lung fields. Transbronchial biopsy reveals small, interstitial non-caseating granulomas. Which of the following is consistent with her diagnosis?
A. Rupture of surface bleb
B. FEV1/FVC ratio greater than 80%
C. Airway obstruction during expiration with normal inspiration
D. Histiocytic cells resembling tennis rackets
E. Hypocalcemia and hypogammaglobulinemia
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Old 07-31-2011
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Quote:
Originally Posted by ricko335 View Post
A 48-year-old nonsmoking woman has experienced shortness of breath, fever and weight loss for 5 months. On auscultation, fine rales are heard across all lung fields. A CXR shows hilar lymphadenopathy and small, reticulonodular densities in all lung fields. Transbronchial biopsy reveals small, interstitial non-caseating granulomas. Which of the following is consistent with her diagnosis?
A. Rupture of surface bleb
B. FEV1/FVC ratio greater than 80%
C. Airway obstruction during expiration with normal inspiration
D. Histiocytic cells resembling tennis rackets
E. Hypocalcemia and hypogammaglobulinemia
the ans is B
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Old 07-31-2011
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Quote:
Originally Posted by ricko335 View Post
A 48-year-old nonsmoking woman has experienced shortness of breath, fever and weight loss for 5 months. On auscultation, fine rales are heard across all lung fields. A CXR shows hilar lymphadenopathy and small, reticulonodular densities in all lung fields. Transbronchial biopsy reveals small, interstitial non-caseating granulomas. Which of the following is consistent with her diagnosis?
A. Rupture of surface bleb
B. FEV1/FVC ratio greater than 80%
C. Airway obstruction during expiration with normal inspiration
D. Histiocytic cells resembling tennis rackets
E. Hypocalcemia and hypogammaglobulinemia
B its seems to b sarcoidosis ...restrictive lung disease there is also asteroid bodies and shaumaan bodies on microscopy :P
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Old 07-31-2011
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yea. seems to be sarcoidosis . B . young female. fever' wt loss. non-caseous granuloma hilar lyphadenopathy .....
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Old 07-31-2011
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i am with B. restrcitive pattern.
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Old 07-31-2011
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A. Rupture of surface bleb - would present with acute symptoms

B. FEV1/FVC ratio greater than 80% -> sounds sarcoidosis Restrictive lung disease

C. Airway obstruction during expiration with normal inspiration-> Obstructive LD, COPD

D. Histiocytic cells resembling tennis rackets -> Langerhans cells histiocytoses

E. Hypocalcemia and hypogammaglobulinemia->( DiGeorge syndrome )
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Old 07-31-2011
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restrictive lung disease...FEV1/FVC ratio is greater ans is B
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Old 08-01-2011
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Correct Answer

This patient has pulmonary sarcoidosis. This is evidenced by interstitial lung disease with bilateral hilar lymphadenopathy and diffuse reticular densities. Biopsy demonstrating noncaseating granulomas provides a definitive diagnosis. These patients often have hypercalcemia, hypergammaglobulinemia and increased serum ACE levels. Further, the lung disease is categorized as a restrictive pattern with FEV1/FVC ratio equal or greater than 80%.

Rupture of surface bleb often occurs in emphysema. Histiocytic cells resembling tennis rackets is seen in eosinophilic granulomas, such as in Histiocytosis X syndrome.
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