A 72-year-old woman comes to the physician because of a 3-day history of fever, shortness of breath, difficulty
swallowing, chest pain, and cough. She is frail. Physical examination shows tachypnea and equal pulses bilaterally.
Percussion of the chest shows dullness over the right lower lung field. Laboratory studies show arterial hypoxemia
and decreased PCO2. A chest x-ray shows an area of opacification in the lower region of the right lung. Which of the
following is the most likely cause of this patient’s condition?
(A) Alveolar proteinosis
(B) Aspiration
© Cigarette smoking
(D) Emphysema
(E) Vasculitis