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  #1  
Old 04-17-2011
Prepping123's Avatar
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Arrow NBME Form 1, Section 1, Q# 1

A homeless 38-year-old man has three months history of decreased appetite, generalized wasting, a low grade fever, and worsening cough, productive of bloody, mucopurulent sputum. He has 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 cells 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.

PS) When answering please mention the reason for the correct and incorrect options so that we can learn from it.
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  #2  
Old 04-17-2011
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They gave you enough clues to tell you it's pulmonary tuberculosis.
Therefore B is the answer (characteristic of caseation necrosis seen in TB)
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  #3  
Old 04-17-2011
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Default B

Not quite sure but would it be B) ? I'm thinking TB.
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Old 04-17-2011
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Yep answer is B) guys.. Gotta love TB!
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Old 04-17-2011
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the ans is definitely B the q gives clear clinical picture of a case of tb n cavitation in apices is a classic x ray finding the options included re regarding histopathology of tb tht is best xplained in B tht is caseuos necrosis n granuloma formation
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  #6  
Old 04-17-2011
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Smile nice one

it TB (b)

why? because marcrophage the major role in granuloma fromation which is convert it epitheloid cell and giant cell under the influnce of TNF and IL-1.

and that why the other choice r wrong.
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  #7  
Old 04-17-2011
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Heheh B.............Goljan high yield !!
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Old 08-22-2015
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Default Why not klebsiella

Cavitary lesion in the apices is one clue , however the hx of an alcoholic with bloody sputum also denotes the likelihood of klebsiella which is also one of the bacterial causes of cavitation so why not E?
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The above post was thanked by:
shr95 (08-23-2015)



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Microbiology-, NBME-, Pathology-, Respiratory-, Step-1-Questions

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