A 45-Year-Old Previously Healthy Man Is Brought to the Emergency

A 45-year-old previously healthy man is brought to the emergency department after being hit by a car while cycling.  The patient is hypotensive and tachycardic on arrival and has comminuted fractures of the pelvis and lower extremities.  Volume resuscitation is performed with intravenous fluids and multiple units of packed red blood cells and plasma.  Several hours later, the patient develops worsening dyspnea and hypoxia.  Chest imaging reveals new bilateral infiltrates.  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?

A) Alveolar macrophages
B) Ciliated epithelial cells
C) Club cells (previously Clara cells)
D) Goblet cells
E) Type I pneumocytes
F) Type II pneumocytes

Correct Answer:

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