nbme pulm - 25hydroxylase

[ArchivalUser]

. A 28-year-old man comes to the physician because of a 1-month history of severe shortness of breath with exertion. He has smoked 1 pack of cigarettes daily for 10 years. His father and his uncle died in their 40s of lung disease. The lungs are hyperresonant to percussion. Breath sounds are diffusely decreased. Pulse oximetry on room air while the patient is at rest shows a normal oxygen saturation that decreases to less than 86% when the patient climbs one flight of stairs. Pulmonary function tests show an FEV1 of 1.0 L/min (25% of predicted) and an FVC of 3.3 L/min (70% of predicted). Five years ago, his lung function was normal. Histologic examination of tissue obtained on biopsy is most likely to show which of the following?

A. Bronchopulmonary dysplasia
B. Chronic bronchitis
C. Interstitial fibrosis
D. Obliterative bronchiolitis
E. Panacinar emphysema

[ArchivalUser]

e!!

[ArchivalUser]

eeee........the vignett is typical of alpha 1 antitrypsin deficiency which normally removes elastase produced by neutrophils in the lung and its deficiency leads to destruction of the acini by elastase which leads to pan acinar emphysema

[ArchivalUser]

v good