A 70-year-old man comes to the emergency room for worsening leg pain and a rash consistent with wet gangrene. He has no history of skin infections but has type 2 diabetes mellitus and has smoked 2 packs of cigarettes daily for 20 years. Three days after admission, he becomes increasingly hypoxic and tachypneic. Endotracheal intubation is performed for respiratory support. Despite aggressive resuscitation, the patient dies 24 hours later. Autopsy examination of the lungs shows protein-rich fluid within the alveolar airspaces. Breakdown of the barrier formed by which of the following cells most likely contributed to this patient's pulmonary pathology?

Question

A 70-year-old man comes to the emergency room for worsening leg pain and a rash consistent with wet gangrene. He has no history of skin infections but has type 2 diabetes mellitus and has smoked 2 packs of cigarettes daily for 20 years. Three days after admission, he becomes increasingly hypoxic and tachypneic. Endotracheal intubation is performed for respiratory support.  Despite aggressive resuscitation, the patient dies 24 hours later.  Autopsy examination of the lungs shows protein-rich fluid within the alveolar airspaces.  Breakdown of the barrier formed by which of the following cells most likely contributed to this patient's pulmonary pathology?

Quizplus · Accepted Answer

Eductional Objective: Acute respiratory distress syndrome is a severe inflammatory reaction that occurs in the lungs and results in hypoxemia and noncardiogenic pulmonary edema. Pulmonary injury leads to an inflammatory response resulting in breakdown of the capillary-alveolar barrier (created by type I pneumocytes and endothelial cells), increased capillary permeability, intraalveolar fluid accumulation, and hyaline membrane formation.

A 70-Year-Old Man Comes to the Emergency Room for Worsening