COPD USMLE Step 1 Practice Question
A 59-year-old woman with a 40 pack-year smoking history presents with a 4-year history of chronic productive cough and dyspnea on exertion. Vital signs show BP 138/82 mmHg, HR 96/min, RR 22/min, and SpO2 88% on room air. Spirometry reveals FEV1/FVC ratio of 0.62. She denies orthopnea. Currently takes only albuterol as needed. She meets diagnostic criteria for chronic bronchitis. Which of the following best describes the pathophysiology of her disease?
Answer choices
- AImmune complex deposition in alveolar basement membrane
- BMucus gland hyperplasia and goblet cell metaplasia causing airflow obstructionCorrect answer
- CBronchial smooth muscle destruction with bronchial dilation
- DLoss of surfactant from type II pneumocyte injury
- EDestruction of alveolar walls distal to terminal bronchioles
- FBronchiectasis causing chronic productive cough with pathologic bronchial dilation visible on CT as signet ring signs
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