Qd 1881 uworld plz help Acute HF .

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sadaca

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hey guys, for anyone who has uworld, have you done qd 1881 on acute HF? I picked C- hemosidrin laden macrophages . The patient has all the signs of left sided HF then why is it not this answer? How do we know?
Very lost on this. Plz help

appreciate it

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hemosiderin laden macrophages are indicative of long-standing heart failure, as the backup of blood into the lungs causes capillary rupture and the macrophages breakdown the RBCs. Since this person just went into heart failure, you will get a transudate in the lung because fluid will leak out of the capillaries.
 
I agree with above. I highlighted that it said 6 hours. If they had presented the patient as having had hypertension for many years of CHF, then I'd be more inclined to say hemosiderin laden macrophages. The fact that it just occurred, you could imagine a back up in the lungs --> increase in hydrostatic pressure --> transudate
 
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