A 62-Year-Old Man Is Evaluated for Worsening Cough, Shortness of Breath

A 62-year-old man is evaluated for worsening cough, shortness of breath, and episodic hemoptysis over the past 6 months.  The patient has also had a 15-kg (33-lb) weight loss over the same period without any change in his diet or activity level.  He has a 50-pack-year smoking history and does not use alcohol or illicit drugs.  BMI is 18 kg/m².  The patient appears cachectic with temporal wasting and generalized loss of muscle mass.  Chest x-ray reveals a large lung mass with mediastinal lymphadenopathy and pleural effusion.  Which of the following cellular processes is most likely responsible for this patient's muscle loss?

A) Covalent attachment of ubiquitin to muscle proteins
B) Plasma membrane rupture with leakage of cellular contents
C) Plasma membrane instability due to defective dystrophin
D) Progressive shortening of chromosomal telomeres
E) Reprogramming of undifferentiated mesenchymal cells

Correct Answer:

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