alenka
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as far as Kaplan books go-they say that recurrent pneumonias have to make you think of malignancy,so here's only one option.
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| guayoman
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I agree with alenka. Because of his age. In a younger person Kartagener would be a good explanation too.
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| cyra
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Kartagener's wouldn't be localized to just one lobe...so I'd chuck that out.I found it hard to decide between B and C but then to think of it...an immunodeficiency like panhypogammaglobulnemia shouldn't have such a localized effect unless there was some form of obstruction to the airway predisposing to infection at one particular lobe.
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| MAZI
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i agree with cyra
this is the localized, not diffuse problem
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| achilles
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agree with cyra
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| nida
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The answer is B.
Bronchiectasis is an abnormal and permanent dilation of the airway resulting from a number of insults. The most common cause is severe viral infection or bacterial pneumonia with subsequent airway destruction. The most commonly associated organisms include Staphylococcus aureus, Klebsiella, and anaerobes. Mycobacterium tuberculosis can cause bronchiectasis; similarly, Mycobacterium avium complex has been described as both causing bronchiectasis and colonizing already bronchiectatic airways. These diseases result in focal bronchiectasis. Allergic bronchopulmonary aspergillosis is associated with central bronchiectasis from chronic airway inflammation and mucus inspissation. Impaired host defense mechanisms such as cystic fibrosis, immunodeficiency such as with panhypogammaglobulinemia and HIV, and ciliary dysfunction as in Kartagener's syndrome are associated with diffuse bronchiectasis. Focal bronchiectasis is usually caused by other disorders that lead to localized airway obstruction, such as enlarged lymph nodes, carcinoid tumors, and endobronchial lung cancer.
(From Harrison- Self-assessment test)
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