emphysema adapt to hii They may maintain nearly normal PO, and PCO, levels despite advanced disease. With greater disease severity and further loss of capillary perfusion, the DLCO falls, leading to exercise-related and, when severe, resting arterial hemoglobin desaturation. Hypercapnia, respiratory acidosis, and a compensatory metabolic alkalosis are common in severe disease. 6. Polycythemia—As in chronic bronchitis, chronic hypoxemia is frequently associated with an elevated hematocrit. CHECKPOIN' 27. What is the leading cause of COPD? 28. Describe the pathophysiologic changes in emphysema versus chronic bronchitis, 29. Mutations of which protein are strongly correlated with an increased risk of emphysema? 30. Name eight symptoms and signs of chronic bronchitis. 31, Name six symptoms and signs of emphysema. RESTRICTIVE LUNG DISEASE: IDIOPATHIC PULMONARY FIBROSIS Interstitial lung disease, or diffuse parenchymal lung disease, is a descriptive term that encompasses more than 180.differentdisorders. These disorders are grouped together because of shared pathologic, physiologic, clinical, and radiographic features. Diffuse parenchymal lung diseases are characterized by a cells, mesenchymal cells, and collagen-rich extracellular matrix, leading to fibrosisand:capillaryremodeling (* gure °~23). Diffuse lung fibrosis leads to. increased lung elastic recoil, decreased lung compliance and lung volumes, impaired oxygen diffusion, and alterations in ¥/Q matching, leading to impairment in gas exchange through a pattern known as restrictive lung disease.