Which of the following is the earliest pathologic change that causes airway dysfunction?

Question

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The lungs of a newborn with CF are histologically normal at birth. However, airway dysfunction appears to begin as early as the first year of life, with the earliest pathological change being thickened mucus and plugging of the submucosal gland ducts in the large airways. These changes appear to precede chronic infection and inflammation.

Which of the Following Is the Earliest Pathologic Change That