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  #1  
Old 08-23-2010
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Lungs clerk in a bird pet store

A 33-year-old woman presents with worsening episodes of fever, non-productive cough, and dyspnea over 5 months. She is a nonsmoker with no past medical history. She recently immigrated from Europe and works as a clerk in a bird pet store. There are no abnormal findings on physical examination. A CXR shows fine, diffuse, nodular infiltrates in all lung fields. Which of the following is consistent with her disease?
A. Progressive interstitial fibrosis
B. Type III hypersensitivity reaction
C. Type IV hypersensitivity reaction
D. Type I hypersensitivity reaction
E. Langerhans cell proliferation
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Old 08-23-2010
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E. Langerhans cell proliferation...?? or it can be type 4 hypersensitivity reaction if we consider histoplasmosis....
hmmmm.....will go with type 4 reaction....
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Old 08-23-2010
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idk. whenever birds are involved we're supposed to think of Chlamydia psittaci and Histoplasma right? idk what kind of hypersensitivity reaction would be involved in either case.
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Old 08-23-2010
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e? i know there's proliferation of macrophages for sure.
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Old 08-23-2010
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E. langerhans cell option
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Old 08-24-2010
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E. Langerhans cell proliferation ??
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Old 08-24-2010
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The correct answer is B.
Dust from bird feathers can result in an extrinsic allergic alveolitis. This type of pulmonary alveolitis is a result of an antigen-antibody complex formation type III hypersensitivity reaction. Removing the antigen source will improve the symptoms.

Type I hypersensitivity is seen with extrinsic asthma, where an allergen attaching to IgE bound to mast cells causing mast cell degranulation. Type IV hypersensitivity occurs with cell-mediated immune responses to tuberculosis. Interstitial fibrosis and Langerhans cell histiocytosis have a progressive course (not episodic) and lead to restrictive lung disease.
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Old 08-24-2010
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Quote:
Originally Posted by doctorF View Post
The correct answer is B.
Dust from bird feathers can result in an extrinsic allergic alveolitis. This type of pulmonary alveolitis is a result of an antigen-antibody complex formation type III hypersensitivity reaction. Removing the antigen source will improve the symptoms.

Type I hypersensitivity is seen with extrinsic asthma, where an allergen attaching to IgE bound to mast cells causing mast cell degranulation. Type IV hypersensitivity occurs with cell-mediated immune responses to tuberculosis. Interstitial fibrosis and Langerhans cell histiocytosis have a progressive course (not episodic) and lead to restrictive lung disease.
which Q bank u r using?...
hope i wont see this type of Q in exam.....
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Old 08-25-2010
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Quote:
Originally Posted by khushboo View Post
which Q bank u r using?...
hope i wont see this type of Q in exam.....

lolzzz this is from the gunnertraining question bank i won from here!!
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Old 08-25-2010
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Wow -sometimes these people really take these Qbanks to the next level by removing any preformed associations we may have in our heads. Birds are supposed to be a HUGE keyword for histo and c. psittaci and now we're supposed to remember birds are dusty? Don't they clean the birds in the pet store ?

One thing though - I'm a little confused... doesn't dust cause asthma and therefore a type I hypersensitivity? I thought Type III was more systemic like SLE. FA's table lists something called "Hypersensitivity Pneumonitis eg. Farmer's Lung" - is this an example of that? (FA2010 p.209)
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Old 08-25-2010
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Quote:
Originally Posted by ashishkabir View Post
Don't they clean the birds in the pet store ?
hehehe.....nice one....
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Immunology-, Microbiology-, Pathology-, Respiratory-, Step-1-Questions

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