Try it
Pathology · Systemic pathology: cardiovascular, respiratory, GI, renal, endocrine, CNS, bone and soft tissue
Sample itemA previously healthy 45-year-old develops fever and cough, and within two weeks needs mechanical ventilation. CT shows bilateral ground-glass opacities. Lung biopsy shows hyaline membranes and fibroblast proliferation in the airspace walls, with no cause found. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Acute interstitial pneumonia
Acute interstitial pneumonia (Hamman-Rich) is idiopathic diffuse alveolar damage with an abrupt onset and high mortality. The hyaline membranes and organising phase are the same as in ARDS, but no trigger is found.
Option by option
A. Desquamative interstitial pneumonia
Desquamative pneumonia shows alveoli filled with pigmented macrophages in smokers, with a subacute course.
B. Usual interstitial pneumonia
Usual interstitial pneumonia is a chronic process with subpleural honeycombing and fibroblastic foci.
C. Acute interstitial pneumonia (correct)
Correct. Rapid respiratory failure with idiopathic diffuse alveolar damage defines this disease.
D. Cryptogenic organising pneumonia
Organising pneumonia shows intraluminal plugs of granulation tissue, not hyaline membranes.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
More Pathology questions
- Systemic pathology: cardiovascular, respiratory, GI, renal, endocrine, CNS, bone and soft tissueA 78-year-old diabetic man has a hand X-ray showing pipe-stem calcification of the radia…
- Systemic pathology: cardiovascular, respiratory, GI, renal, endocrine, CNS, bone and soft tissueColonoscopy in a 62-year-old shows multiple outpouchings in the sigmoid colon. Histology…
- Systemic pathology: cardiovascular, respiratory, GI, renal, endocrine, CNS, bone and soft tissueA 35-year-old man has gynaecomastia and a testicular mass with a golden-brown cut surfac…
- Systemic pathology: cardiovascular, respiratory, GI, renal, endocrine, CNS, bone and soft tissueA 65-year-old woman has a firm, solid, unilateral ovarian mass found incidentally. Histo…