Respiratory: stages of lobar pneumonia: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Respiratory: stages of lobar pneumonia

Sample item

A 50-year-old alcoholic man has high fever and rusty sputum. On the third day of illness, a lung specimen is airless, red-purple and firm like liver. Microscopy shows alveoli packed with neutrophils, fibrin and numerous extravasated red cells. Which stage is this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Red hepatisation

Lobar pneumonia passes through congestion (day 1 to 2), red hepatisation (day 2 to 4), grey hepatisation (day 4 to 8) and resolution. In red hepatisation, alveoli are filled with neutrophils, fibrin and intact red cells. In grey hepatisation, red cells lyse and the lung turns grey-brown.

Option by option

  • A. Grey hepatisation

    Grey hepatisation shows fibrin and neutrophils with disintegrating red cells and a pale cut surface.

  • B. Congestion

    Congestion shows engorged capillaries and oedema fluid with few neutrophils, and the lung is still aerated.

  • C. Red hepatisation (correct)

    Correct. Neutrophils, fibrin and many red cells in solid lung define red hepatisation.

  • D. Resolution

    Resolution shows enzymatic digestion of exudate with macrophage clearance, and restoration of aeration.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Red hepatisation. Lobar pneumonia passes through congestion (day 1 to 2), red hepatisation (day 2 to 4), grey hepatisation (day 4 to 8) and resolution.

Why is "Grey hepatisation" not the answer?

Grey hepatisation shows fibrin and neutrophils with disintegrating red cells and a pale cut surface.

Why is "Congestion" not the answer?

Congestion shows engorged capillaries and oedema fluid with few neutrophils, and the lung is still aerated.

Why is "Resolution" not the answer?

Resolution shows enzymatic digestion of exudate with macrophage clearance, and restoration of aeration.

What concept does this question test?

It tests Respiratory: stages of lobar pneumonia in Pathology. In red hepatisation, alveoli are filled with neutrophils, fibrin and intact red cells. In grey hepatisation, red cells lyse and the lung turns grey-brown.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory: stages of lobar pneumonia?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.