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  #1  
Old 03-12-2013
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Lungs pink-staining homogenous proteinaceous hyaline material in alveoli

An 80-year-old woman dies shortly after admission to the hospital because of a 3-day history of progressively increasing shortness of breath. She had a history of heart failure. Examination of the lungs during autopsy shows alveolar damage with distended lymphatics, congested alveolar capillaries, and pink-staining homogenous proteinaceous hyaline material in alveoli. Which of the following is the most likely cause of these findings?

A. Amyloidosis
B. Aspiration pneumonitis
C. Emphysema
D. Pneumonia
E. Pulmonary edema
F. Septic shock
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  #2  
Old 03-12-2013
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pneumonia i guess
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Old 03-12-2013
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F. ARDS due to septic shock.
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  #4  
Old 03-13-2013
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Idea!

Aspiration Pneumonitis leading to ARDS.
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  #5  
Old 03-13-2013
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confused btw F and E,
F b'se it seems like this person had ARDS due tp septic shock
E b'se even if the person had septic shock( this is assumed by the nature of the stem question) and heart failure (this is in the stem) pulmonary edema would cause immediate death logically
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Old 03-13-2013
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They say nothing about any signs of infection like fever, hypotension so I wouldn't jump onto septic shock. They also don't tell us that the lady was bed-bound or in any such state that would predispose to aspiring into the lungs... the biopsy shows no bacteria or puss.

The biopsy points towards decompensated heart leading to pulmonary edema... the pressure in the pulmonary capillaries rose so high that the capillaries became congested to the point of damage, eventually breaking down and releasing proteins into the alveoli - inactivating the surfactant and forming hyaline membranes. The lymphatic congestion also points towards such an etiology.

Absence of inflammatory cells and the history of heart failure are what I'm looking at.

More opinions?
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Old 03-13-2013
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E) pulmonary edema. As stated by the person above me, the heart failure and resultant pulmonary edema fits the clinical picture.
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Old 03-15-2013
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Amyloidosis..
Deposits of amyloid are seen pink on h and e stain
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Old 03-15-2013
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well heart failure cells also stain pink...then pulomonary edema
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  #10  
Old 03-19-2013
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I was confused about the pink-staining material within the alveoli, but apparently it is transudate. Answer is pulmonary edema
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