Left-sided heart failure is characterized by

Choice A reason: This is not the cause of airway obstruction in asthma. Collapse of the cartilaginous rings in the bronchi is a feature of tracheobronchomalacia, a condition in which the airways are weak and floppy.

Choice B reason: This is not the cause of airway obstruction in asthma. Type II alveolar cell injury and decreased surfactant are associated with acute respiratory distress syndrome (ARDS), a condition in which the alveoli are damaged and filled with fluid.

Choice C reason: This is not the cause of airway obstruction in asthma. Alveolar changes and pulmonary congestion are seen in chronic obstructive pulmonary disease (COPD), a condition in which the alveoli are enlarged and lose their elasticity.

Choice D reason: This is the correct cause of airway obstruction in asthma. Asthma is a chronic inflammatory disorder of the airways, characterized by mucus secretion, bronchoconstriction, and airway edema. These factors reduce the diameter of the airways and increase the resistance to airflow.

Choice A reason: Hyperplasia and deformation of bronchial cartilage are not the causes of airway obstruction in COPD type B. Bronchial cartilage is the rigid structure that supports the bronchi, the large airways that branch from the trachea. Hyperplasia is an increase in the number of cells, and deformation is a change in the shape or structure of the cells. These processes can affect the bronchial cartilage, but they do not directly obstruct the airway.

Choice B reason: Loss of alveolar elastin is not the cause of airway obstruction in COPD type B. Alveolar elastin is the elastic fiber that allows the alveoli, the tiny air sacs at the end of the bronchioles, to expand and recoil during breathing. Loss of alveolar elastin is a characteristic of COPD type A (emphysema), which causes the alveoli to lose their shape and collapse. This reduces the surface area for gas exchange, but it does not obstruct the airway.

Choice C reason: Pulmonary edema is not the cause of airway obstruction in COPD type B. Pulmonary edema is the accumulation of fluid in the lungs, usually due to heart failure or lung injury. It causes shortness of breath, coughing, and crackles in the lungs. It can impair gas exchange and oxygenation, but it does not obstruct the airway.

Choice D reason: Thick mucus, fibrosis, and smooth muscle hypertrophy are the causes of airway obstruction in COPD type B. Thick mucus is the result of chronic inflammation and infection of the bronchi, which stimulates the mucus glands to produce more and thicker mucus. Fibrosis is the formation of scar tissue in the bronchial walls, which narrows the airway and reduces its elasticity. Smooth muscle hypertrophy is the enlargement of the smooth muscle cells that surround the bronchi, which increases the airway resistance and causes bronchospasm. These processes combine to obstruct the airway and cause chronic cough, wheezing, and dyspnea.