A 58-year-old man with COPD has imaging showing dilated airspaces predominantly in the upper lobes. Which of the foliowing best explains his condition?A. Protease-antiprotease imbalance due to smokingB. Deficiency of lysosomal glucocerebrosidaseC. Inactivation of surfactant protein C gene D. Autosomal dominant loss of CFTR function E. Mutation in SERPINA1 gene causing deficiency
Added by Holly H.
Step 1
The patient is a 58-year-old man with COPD (Chronic Obstructive Pulmonary Disease) and imaging shows dilated airspaces predominantly in the upper lobes. Show more…
Show all steps
Your feedback will help us improve your experience
Adi S and 85 other Biology educators are ready to help you.
Ask a new question
Labs
Want to see this concept in action?
Explore this concept interactively to see how it behaves as you change inputs.
Key Concepts
Recommended Videos
CASE STUDY Miguel Perez is a 65-year-old farmer who has managed his own large farm for many years. He has smoked two packs of cigarettes a day for 35 years. During the last few years Mr. Perez has experienced slight shortness of breath and a mild cough with activity. He also coughs after arising each morning. Mr. Perez noticed recently that he has difficulty climbing the stairs at home because of fatigue and he must stop at intervals to catch his breath. He has also noticed being short of breath even sometimes at rest. He has lost 10 pounds in the last 2 months. He has been sleeping sitting up or propped by several pillows. On admission to the emergency room, he is a thin, frail-looking man in acute respiratory distress. He is restless and breathing rapidly. He is sitting on the side of the bed leaning on the bedside table. His heart rate is 120, respirations are 30, and blood pressure is 140/80. Auscultation of the lungs reveals decreased breath sounds with expiratory wheezes. His chest has an increased anteroposterior diameter, giving it a barrel shape, and he is using accessory muscles to breathe. Arterial blood gas results reveal a decreased Po2, an increased Pco2, a low pH, and a high bicarbonate level. Pulmonary function tests reveal decreased tidal volume, decreased vital capacity, increased total lung capacity, and a prolonged forced expiratory volume. A chest x-ray reveals a flat low diaphragm, hyperinflation of the lungs, clear lung fields, and no evidence of cardiac enlargement. He is started on 2 liters of oxygen by nasal cannula in the emergency room. 1. Which two of the following reasons are the most likely causes of Mr. Perez's dyspnea? A. Increased lung compliance and decreased elastic recoil B. Decreased elastic recoil and decreased lung compliance C. Decreased lung compliance and increased elastic recoil D. Increased elastic recoil and increased lung compliance 2. The causes of Mr. Perez's barrel chest include A. Excessive secretions B. Severe hypoxemia C. Hyperinflation of the lungs D. Thickening of the bronchial mucosa 3. Retention of carbon dioxide in individuals with chronic obstructive pulmonary disease (COPD), such as Mr. Perez's, is caused by what mechanism? A. Alveolar hyperventilation B. Dilation of the bronchial tree C. Alveolar hypoventilation D. Decreased dead space 4. Which of the following best explains Mr. Perez's weight loss? A. Cigarette smoking decreases his sense of taste, thus decreasing his appetite B. COPD increases the body's need for calories C. Cigarette smoking increases the basal metabolic rate leading to weight loss D. COPD prevents the body from using nutrients
Adi S.
Which statement is correct? a. In pulmonary embolism, an embolus travels from a leg to the lungs through the right side of the heart. b. The mutated protein responsible for cystic fibrosis secretes chloride ions. c. Cystic fibrosis is a common recessive genetic disease. d. One quarter of the world's population is infected by Mycobacterium tuberculosis. e. Elastase destroys the small airways in emphysema.
Sri K.
A 45-year-old man presented with a complaint of an increasingly persistent cough that produced moderately thick, white mucus. The patient stated that the cough had been present for several years and was particularly severe in the morning upon awakening. His wife was more bothered by the cough than he was and had sent him to the physician so that he might be convinced to stop smoking. On questioning, the patient, who was about 30 lb overweight and had been smoking two packs of cigarettes per day for 20 years, had no other ailments. The physician recommended that he stop smoking, and the patient was lost to follow-up. Ten years later, the patient reappeared in obvious distress, coughing with wheezing sounds in his chest and complaining of "tightness" in his chest. The condition had arisen after the patient developed an upper respiratory tract infection. He complained that the wheezing and tight feeling in his chest had occurred on other occasions over the past few years, but that he was currently suffering more than usual. Pulmonary function tests showed some decrease in FEV1. The patient was treated with bronchodilators and antibiotics, and responded satisfactorily. Over the next several years, the patient's wife began bringing the patient for his visits. She noted that he had increasing somnolence and some personality changes, and he complained of morning headaches. Laboratory tests repeatedly showed: - Elevated red blood cell counts but normal white cell counts - Low blood oxygen, elevated CO2, and marked cyanosis Pulmonary function tests revealed: - Increased total lung capacity - A marked decrease in FEV1 - A decreased diffusing capacity (also called transfer factor) relative to an evaluation 14 years earlier -- diffusing capacity is one measure of the ability of the lung to transport gas into and out of the blood. The patient also had distended neck veins and an enlarged, tender liver. A chest x-ray revealed hyperlucent lung fields and a depressed diaphragm, pulmonary hypertension as demonstrated by enlarged pulmonary arteries, right ventricular dilation and hypertrophy, and increased vascular markings at the hilum. The patient was finally admitted to the hospital markedly cyanotic with distended neck veins and an enlarged, tender liver. After a progressively downhill course, the patient died. Questions to answer: 1. What is the primary disease that this patient suffered from? 2. What is the most likely etiology of the disease presented by this patient, if known? 3. What is the most likely underlying mechanism that gives rise to this disease? 4. What are the key abnormal functions and/or morphologies that are presented by this patient?
Recommended Textbooks
Biology for AP Courses
Objective Biology for NEET
Introduction to General, Organic and Biochemistry
Transcript
18,000,000+
Students on Numerade
Trusted by students at 8,000+ universities
Watch the video solution with this free unlock.
EMAIL
PASSWORD