A 58-year-old man comes to the office due to exertional dyspnea and cough. His symptoms started 6 months ago and have progressively worsened. The patient has no significant medical history and takes no medications. He smoked a pack of cigarettes daily for 27 years but quit 2 years ago. Vital signs are normal. Physical examination shows bilateral inspiratory crackles and digital clubbing. CT scan of the chest is shown in the exhibit. Which of the following changes are most likely present in this patient's lung tissue?

Question

A 58-year-old man comes to the office due to exertional dyspnea and cough.  His symptoms started 6 months ago and have progressively worsened.  The patient has no significant medical history and takes no medications. He smoked a pack of cigarettes daily for 27 years but quit 2 years ago. Vital signs are normal.  Physical examination shows bilateral inspiratory crackles and digital clubbing.  CT scan of the chest is shown in the exhibit.  Which of the following changes are most likely present in this patient's lung tissue?

Quizplus · Accepted Answer

Eductional Objective: Idiopathic pulmonary fibrosis is an interstitial lung disease characterized by chronic progressive dyspnea, nonproductive cough, inspiratory crackles, and subpleural (peripheral) lung honeycombing.  In IPF, repetitive microinjury to the alveolar epithelium (eg, smoking, acid reflux) is focally repaired by fibroblast proliferation/collagen deposition instead of normal restoration via type 2 pneumocyte differentiation.

A 58-Year-Old Man Comes to the Office Due to Exertional