This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
True about panacinar emphysema: March 2011 
Select and explain. 
A. Apical region commonly involved, B. Usually presents in 6th decade, C. Alpha-1 antitrypsin deficiency, D. Involves whole lung
C: Alpha-1 antitrypsin deficiency
Answer: C: Alpha-1 antitrypsin deficiency 
Explanation: Ans. C: Alpha-1 antitrypsin deficiency Panacinar emphysema refers to abnormally large airspaces evenly distributed within and across acinar units. Panacinar emphysema is usually observed in patients with alphal-antitrypsin deficiency Emphysema/ pink puffers: Permanent and destructive enlargement of airspaces distal to the terminal bronchioles without obvious fibrosis and with loss of normal architecture Panacinar emphysema involves both central and peripheral poions of the acinus Smoking is the commonest precipitant Breathlessness is characteristic feature