(NEXT TWO QUESTIONS ARE LINKED) QUESTION 1: 71-year-old man presents to his PCP because of progressive dyspnea and cough

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(NEXT TWO QUESTIONS ARE LINKED) QUESTION 1: 71-year-old man presents to his PCP because of progressive dyspnea and cough. He worked during 38 years in the construction industry. His work consisted of assembling the ceilings of small houses in a small town in Mexico. Vital signs: HR88bpm, RR 18, BP 140/80, T:36.4°C, Sat 02 93%. On auscultation end- inspiratory crackles are present. Normal cardiac S1 and S2 sounds. He refers the dyspnea presents when he climbs stairs. Chest x-ray was requested shows multinodular and reticular pattern.

A It results from the inhalation of thermophilic Actinomyces species (ubiquitous organisms usually found in decaying compost or hay) setting in motion an inflammatory and pro-fibrotic response in the alveolar walls 8 It is caused by diverse mutations in genes encoding proteins involved in surfactant trafficking or secretion, ATP-binding cassette protein member 3 (ABCA3) being the most frequently mutated gene C It is caused by infection or mechanical trauma that induces pneumocyte injury, endothelial activation and an excessive inflammatory response in the alveolar walls Antigen-specific immunoglobulin and complement activation and deposition in the lung immune complex-induced tissue injury (type Ill hypersensitivity) E Chronic occupational exposure to inorganic particles. Particles are trapped deeper into the lungs. Once phagocytosed by macrophages, activate the inflammasome and stimulate the release of inflammatory mediators and pro-fibrogenic factors STIONS VON Previous Next