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5200 Pathology

A 20-year-old female presents with a 5-day history of fatigue, lowgrade fever, and sore throat. Physical examination reveals bilateral enlarged, tender cervical lymph nodes, an exudative tonsillitis, and an enlarged spleen. A complete blood cell count reveals the hemoglobin and platelet counts to be within normal limits. The total white blood cell count is increased to 9200 cells per uL. Examination of the peripheral blood reveals the presence of atypical mononuclear cells with abundant cytoplasm. These cells have peripheral condensation of the cytoplasm, which gives them a “ballerina ski” appearance. Which one of the listed findings is most likely to be present in this individual?

AAggregates of mononuclear cells with cytoplasmic Birbeck granules in the liver
BElevated levels of d-ALA in the urine
CGroup A streptococcus on culture of the tonsillar exudate
DHeterophil antibodies in the serum
Pathology
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5201 Pathology

A 46-year-old man has had increasing dyspnea with nonproductive cough for the past year. On physical examination he is afebrile and has clubbing of digits. Pulmonary function testing reveals a mild restrictive abnormality along with reduced DLCO. A transbronchial biopsy is performed and microscopic examination shows numerous alveolar macrophages, plump epithelial cells, mild interstitial fibrosis, and loss of respiratory bronchioles. Lamellar bodies and iron pigment are present within these macrophages. Which of the following is the most likely etiology for his pulmonary disease?

AType I hypersensitivity
BCigarette smoking
CCiliary dyskinesia
DInhalation of mold spores
Pathology
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