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NBME 7 (to samomcos) - sunshine2009
#1



A 65 y. man has exertional dyspnea and a mild nonproductive cough..He is using his accessory muscles for respiration..X-rays of the chest show a flattened diaphragm , bronchovascular patterns that do not extend top the periphery of the lung and a cardiac silhoute that is lengthened and narrowed..Which of the following changes in the resp... airway is most likely in this pateint.


Answ> distention of air spaces distal to terminal bronchi

Would you please explain the mech?

Millions of thanx
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#2
this is not samomcos n this might not be as good as samomcos wd have done....but i'll try

the guy has COPD...... to be more precise Emphysema..... clues: dyspnea, non productive cough, accessory muscles in action, flattened diaphragm, narrowed cardian silhoute.......
(cant be bronchitis cz its characterized by productive cough n th cardiac silhoute wd be wider compared to emhysema)
bcz this is emphysema, the pathology lies distal to terminal bronchioles ( permanent dilation)
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