COPD USMLE Step 1 Practice Question
A 63-year-old male coal miner with 40-year smoking history presents with chronic productive cough and exertional dyspnea. Vital signs: BP 142/88, HR 94, RR 22, SpO2 88% on room air. Chest X-ray reveals multiple small upper lobe nodules with background emphysematous changes. FEV1/FVC ratio is 0.58. He denies hemoptysis. Currently on albuterol inhaler only. Which of the following best describes the pathogenesis of his disease?
Answer choices
- AMutation in BMPR2 causing pulmonary arterial remodeling
- BAspiration of anaerobes causing cavitary necrosis
- CIgE mediated reaction to colonizing fungi in central bronchi
- DLoss of surfactant due to premature birth
- ECarbon laden macrophages trigger chronic inflammatory fibrosisCorrect answer
- FDirect silica contamination within coal dust causing a more aggressive fibrotic response
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