ssrpk
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A 22-year-old schizophrenic patient with an unclear family history is admitted to the hospital for respiratory failure. The patient's past medical history is significant for noncompliance with medication and follow-up, a bout of pneumonia when he was 5, and appendicitis when he was 13. He admits to smoking, excessive alcohol consumption on the weekends, and a single episode of intravenous drug use. Physical examination reveals a disheveled patient with increased AP thoracic diameter. A chest X-ray shows hyperinflation of the lungs but fails to demonstrate any interstitial or lobar infiltrate. Two days into the hospital stay, the patient overdoses on a smuggled intravenous drug. At autopsy, the subpleural blebs are noted in the lungs, especially in the lower lobes. Histologic examination reveals dilation of the alveoli, alveolar ducts, and respiratory bronchioles. There is also evidence of liver cirrhosis. Which of the following is the most likely diagnosis?
(A) Centrilobular emphysema
(B) Cystic fibrosis
(C) Idiopathic pulmonary fibrosis
(D) Panacinar emphysema
(E) Septic bacterial emboli
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| rgr
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Its D
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| trafficjam
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D there's liver cirrhosis as well..may be due to a1 antitrypsin deficiency plus cigerrete smoker.and the dilatation of the entire respiratory unit.
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| doc2003
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I go with D
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| ssrpk
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correct
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| azygous1
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subpleural blebs..lower lobes....panacinar ...
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