An emaciated vagrant found dead in a railway platform shelter is alleged to have died of starvation. Autopsy confirms extreme wasting with virtual absence of subcutaneous fat, but histology of both lungs shows confluent neutrophilic exudate filling alveoli in the lower lobes. The immediate cause of death is best certified as:

• A Bronchopneumonia ✓
• B Pulmonary tuberculosis
• C Pulmonary thromboembolism
• D Aspiration of gastric contents

Explanation

Starved individuals die of impaired immunity permitting terminal infection, and bronchopneumonia is the classical immediate cause of death in chronic starvation. The histology described, neutrophilic exudate filling alveoli in a patchy lower lobe distribution, is diagnostic of bronchopneumonia rather than the caseating granulomas of tuberculosis, the vessel occlusion of embolism, or the foreign material and food particles of aspiration.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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