A 49-year-old man with untreated HIV presents with fever (38.5°C), night sweats, and hemoptysis. He reports a 3-month history of progressive weight loss and denies current cough or dyspnea. Vital signs show HR 92/min, RR 18/min, BP 118/76 mmHg, and SpO2 98% on room air. Chest radiograph reveals cavitary lesions in the apical upper lobes. CD4 count is 45 cells/μL. Which anatomic factor best explains the location of these lesions?
- A)Lower oxygen tension favors growth in the lung apices
- B)Mycobacteria preferentially invade bronchiolar smooth muscle
- C)Higher oxygen tension favors growth in the lung apicesGABARITO
- D)Regional surfactant deficiency causes apical alveolar collapse
- E)Pulmonary venous congestion is greatest in the upper lobes
Explicação
Higher oxygen tension favors growth in the lung apices is correct. Reactivation tuberculosis classically involves the apical upper lobes because Mycobacterium tuberculosis is an obligate aerobe that thrives in well oxygenated tissue. Cavitary disease, night sw... Ver explicação completa e trilha adaptativa →