NBME 3 spoiler - need help!

[kgal1]

An 80-year-old woman dies shortly after admission to the hospital because of a 3-day history of progressively increasing shortness of breath. She had a history of heart failure. Examination of the lungs during autopsy shows alveolar damage with distended lymphatics, congested alveolar capillaries, and pink-staining homogenous proteinaceous hyaline material in alveoli. Which of the following is the most likely cause of these findings?

A. Amyloidosis
B. Aspiration pneumonitis
C. Emphysema
D. Pneumonia
E. Pulmonary edema
F. Septic shock

is this ARDS?
i feel like i have a reason to choose any one of these answers...
can't even seem to narrow this down...
anyone want to try

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[Pegsie]

Her history, plus the description of congested capillaries makes me think of pulmonary edema. The pink-staining material within the alveoli is transudate. Here's an example.

In ARDS , you'd see hyaline accumulations along the alveoli wall. Also, the alveolar wall will be thickened.

 

[Idiopathic]

Most likely edema. Could be ARDS, but not a common course (i.e. no recent surgery, hx of CHF = likely edema)

 

[Paws]

Yeppers, I said pulm edema. Pink homgenous proteinacious material, history of heart failure, distended lymphatics, death, etc.... System has backed up like bad plumbing.

I always like to think of pulmonary edema as looking like the colloid in thyroid cells. Similar consistency.

Good pictures Pegsie!