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Old 08-11-2009
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Lungs NBME

38 yr man homeless with 3 months history of decreased appetite, generalized wating, low grade fever, and worsening cough productive of bloody mucoperulent productive sputum. 3 years history of alcohol abuse. CRX shows consolidation and cavitary lesions in the apices.
Which of the following is the most likely inflammatory and/or immune response in the lung?

a- Endothelial cellular proliferation, vascular budding, fibroblasts
b -Epithelioid cells, multinucleated giant cells, caseation necrosis
c -Fibroblasts, collagen deposition, replacement of intrinsic tissue
d -Macrophages, lymphocytes, hypergammaglobulinemia
e -Neutrophils, vascular congestion, exudate
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  #2  
Old 08-11-2009
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The guy is having TB for sure
So the correct answer is B
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Old 08-12-2009
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The alcoholism is a distractor pointing you to Klebsiella but it's TB
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