COPD USMLE Step 1 Practice Question
A 47-year-old man with acute pancreatitis develops acute respiratory distress two days after admission. He presents with dyspnea, hypoxemia (SpO2 78% on room air), and bilateral pulmonary infiltrates on chest X-ray. Vital signs: HR 118/min, RR 28/min, BP 132/88 mmHg, temperature 38.2°C. Pulmonary capillary wedge pressure is normal. Arterial blood gas shows PaO2 55 mmHg. He denies orthopnea. Which pathologic finding best explains these findings?
Answer choices
- ACaseating granulomas in the upper lobes
- BDiffuse alveolar damage with hyaline membranesCorrect answer
- CMucus gland hyperplasia in large bronchi
- DNoncaseating granulomas in the interstitium
- ESubpleural bleb rupture with pleural air
- FCardiogenic pulmonary edema from elevated wedge pressure
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