Review Question - QID 100849

This patient's presentation is consistent with chronic obstructive pulmonary disease (COPD). COPD can cause hypoxia severe enough to stimulate erythropoietin (EPO) production by the cortical cells of the kidney.

COPD refers to a group of lung diseases that block airflow and make breathing difficult. In COPD, there is less airflow through the airways because of one or more of the following: the alveoli lose their elastic quality, the walls between the alveoli are destroyed, the walls of the airways become thickened and inflamed, or the airways make more mucus than usual, which can cause obstruction. Note that hallmark finding distinguishing obstructive from restrictive lung disease is a decreased FEV1/FVC ratio. The hypoxia induced by COPD can lead to erythropoietin stimulation and ultimately erythrocyte production.

Incorrect Answers:
Answer 1: In COPD, respiratory acidosis is often seen, thus leading to a renal compensation by an increase in bicarbonate reabsorption/generation.
Answer 3: Nasal polyps are most commonly thought to be caused by allergy, adult asthma, and rarely by cystic fibrosis.
Answer 4: Increased IgE levels are seen more often in allergic/inflammatory pathology and are important targets in intervening with the processes of allergy and asthma.
Answer 5: Pleural effusion refers to excess fluid that accumulates between the two pleural layers. Patients may be asymptomatic or dyspnea. Exam may reveal decreased movement of the chest on the affected side, dullness to percussion over the fluid and diminished breath sounds.