This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Respiratory, Subject name: Medicine
Alpha,anti trypsin deficiency causes 
Select and explain. 
A. centri acinar emphysema, B. panacinar emphysema, C. centrilobar emphysema, D. irregular emphysema
B: panacinar emphysema
Answer: B: panacinar emphysema 
Explanation: Ans b (panacinar -emphysema) Ref Harrison 17th pg 1638Emphysema is classified into distinct pathologic types, the most important being centriacinar and panacinar.Centriacinar emphysema -cigarette smoking- enlarged airspaces in association with respiratory bronchioles- upper lobes and superior segments of lower lobes and is often quite focal.Panacinar emphysema - large airspaces evenly distributed within and across acinar units-Alpha! AT deficiency- lower lobes.Risk factors for the development of COPDTobacco smokeBiomass solid fuel firesOccupational -Coal miners & cadmiumAir pollutionLow birth weightChildhood infections & maternal smoking