A 69-year-old woman with rheumatic heart disease presents with progressive dyspnea and orthopnea. Vital signs: BP 148/92 mmHg, HR 108/min, RR 22/min, SpO2 92% on room air. Physical examination reveals bibasilar crackles and a low-pitched diastolic rumble at the apex. Chest radiograph shows pulmonary vascular congestion with elevated pulmonary venous pressure. B-natriuretic peptide is 450 pg/mL. Jugular venous pulsation is not elevated. Sputum cytology is most likely to show which of the following?
- A)Eosinophils with Charcot Leyden crystals
- B)Foamy macrophages filled with lipid
- C)Histiocytes containing ferritin only
- D)Neutrophils with toxic granulation
- E)Alveolar macrophages containing hemosiderinGABARITO
Explicação
Chronic elevation of pulmonary venous pressure causes capillary rupture and leakage of red blood cells into alveoli. Alveolar macrophages ingest the blood and accumulate hemosiderin, creating heart failure cells in patients with chronic left sided heart failur... Ver explicação completa e trilha adaptativa →