COPD USMLE Step 1 Practice Question
A 66-year-old male smoker presents with 2 years of progressive exertional dyspnea and dry cough. Vital signs show BP 138/82, HR 92, RR 18, SpO2 88% on room air. Examination reveals bibasilar crackles and digital clubbing. High-resolution CT demonstrates subpleural reticular opacities and honeycombing at lung bases. PFTs show reduced DLCO. Chest X-ray shows no acute infiltrates. He denies orthopnea. Which histopathologic feature is most characteristic of this disease?
Answer choices
- ACaseating granulomas centered on hilar nodes
- BDiffuse hyaline membranes lining alveoli
- CNumerous hemosiderin laden macrophages after pulmonary infarction
- DMassive eosinophilic mucus plugging in bronchi
- EFibroblast foci with temporal heterogeneityCorrect answer
- FNon-caseating granulomas with central suppuration and neutrophilic infiltration
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