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NBME 17 Answers

nbme17/Block 0/Question#0 (reveal difficulty score)
60-year-old man progressive shortness of ...
Alveolar macrophage ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pulm repeat

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submitted by โˆ—cassdawg(1780)
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The image shown is one of asbestosis (asbestos bodies resemble dumbbell, as seen here and found FA2020 p677). Aside from the image, he also has the major risk factor of asbestosis of working in a shipyard. Asbestosis typically affects the lower lobes of the lungs (hence the bibasilar crepitant crackles) and carries the ability to cause reticulonodular pulmonary infiltrates / fibrosis.

Similar to the pathology behind silicosis fibrosis, alveolar macrophages respond to aesbestos and release fibrogenic factors.

Alveolar macrophages phagocytize foreign materials, release cytokines and alveolar proteases.

Type I pneumocytes make up the alveolar lining, and Type II pneumocytes generate surfactant and can proliferate into Type I pneumocytes in response to alveolar damage. Kulchitsky cells are cells of origin of small cell lung cancer. Clara cells (now called club cells) are nonciliated bronchiolar exocrine cells that secrete a component of surfactant, degrade toxins, and act as reserve cells.

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flapjacks  A barbell, really. +1
cheesetouch  FA2018 P659 +9
jer040512  eh... more like a shake weight. +2
ali_hassan  @cheesetouch got this wrong because FA2018 don't say nothin about macrophages in Asbestosis +



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