Kerley B lines are seen in: (Repeat)

Ans: A (Pulmonary' edema) Ref: Harrison's Principles of Internal Medicine, 18ed. & Arun Babu T et al. Pulmonary edema. Recent Advances in Pediatrics, Spl Vol-24. Edited by Suraj Gupte.Explanation:Cardiogenic Pulmonary EdemaChest radiographyCardiomegalyKerley-B lines - Thickening of interlobar septaBasilar edemaAbsence of air bronchogramsPresence of pleural effusion (particularly bilateral)EchocardiogramEchocardiography is useful to evaluate left ventricular function, valvular function and pericardial disease.Pulmonary capillary wedge pressure (PCWP)PCWP can be measured with a pulmonary arterial catheter. This method helps in differentiating CPE from NCPE. In CPE, PCWP is elevated and large V waves and rapid Y descent may be seen.Non-Cardiogenic Pulmonary edema (ARDS)Chest radiographyHemodynamic -- Peribronchial and Perivascular cuffing, diffuse streakiness- indicated interlobular fluid and distended lymphatics,Septal lines - Kerley A & B,Butterfly sign - Perihilar opacity (Vascular pedicle > 70 mm),Upper zone involvement is an early finding (Vascular re distribution),Diffuse patchy opacity - late finding, cardiomegaly.Types of Kerley LinesKerley A linesThese are longer (at least 2cm and up to 6cm) unbranching lines coursing diagonally from the hila out to the periphery of the lungs.They are caused by distension of anastomotic channels between peripheral and central lymphatics of the lungs.Kerley A lines are never seen w ithout Kerley B or C lines also present.Kerley B linesThese are short parallel lines at the lung periphery.These lines represent interlobular septa, which are usually less than l cm in length and parallel to one another at right angles to the pleura.They are located peripherally in contact with the pleura near the lung basesThese seen in Congestive Heart Failure (CHF) and Interstitial Lung Diseases (1LD).Kerley C linesThese are the least commonly seen of the Kerley lines.They are short, fine lines throughout the lungs, with a reticular appearance.They represent thickening of anastomotic lymphatics