Carbon monoxide diffusion capacity decreases in all, except :

Answer is C (Alveolar hemorrhage): An elevated D Lco is characteristic of alveolar haemorrhage as in Good pastures syndrome. Hemoglobin contained in erythrocytes in alveolar lumen binds carbon monoxide, so that exhaled CO concentration is diminished and the measured Di increased. Diffusion capacity This is measured by estimating Dix() (carbon monoxide diffusion). It is most useful in assessing disease affecting the Alveolar capillary bed (interstitial lung disease, emphysema) Pulmonary vasculature (pulmonary embolism or prim. pul. hypeension) Decreased Deco (Diffusion capacity) Interstitial lung disease: scarring of alveolar capillary units diminishes area of alveolar capillary bed as well as pulmonary blood volume Emphysema: alveolar walls are destroyed so the surface area of alveolar capillary bed is diminished Recurrent pulmonary embolism and Primary pulmonary hypeension: disease causes a decrease in cross sectional area and volume of pulmonary vasculature Increased Di,co (Diffusion capacity) Alveolar haemorrhage: as in Good pasture's syndrome: haemoglobin contained in erythrocytes in alveolar lumen binds Co so exhaled carbon monoxide concentration is diminished & Deco is increased Congestive hea failure: May be elevated if pulmonary blood volume is increased. Once pulmonary edema ensues DLCO may decrease as and the net Deco depends on the opposing influences.