**Core Concept**
Fresh water drowning leads to pulmonary edema due to the osmotic movement of water from the alveoli into the bloodstream, resulting in hemorrhagic lung edema. The lungs also exhibit congestion, hemorrhage, and emphysema aerius due to the influx of water.

**Why the Correct Answer is Right**
The lungs in fresh water drowning show characteristic changes such as congestion, hemorrhage, and emphysema aerius. This is due to the sudden influx of water into the lungs, which leads to an increase in hydrostatic pressure, causing fluid to move from the alveoli into the bloodstream. The water also causes damage to the alveolar-capillary membrane, resulting in hemorrhage and edema.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is not a characteristic change seen in fresh water drowning. However, it could be a change seen in salt water drowning, which leads to a different set of pathophysiological changes.
**Option B:** This option is a characteristic change seen in fresh water drowning. The lungs exhibit congestion and hemorrhage due to the influx of water.
**Option C:** This option is a characteristic change seen in fresh water drowning. Emphysema aerius is a result of the air spaces in the lungs being filled with water, leading to a characteristic "cherry red" appearance on autopsy.

**Clinical Pearl / High-Yield Fact**
It is essential to note that the type of water (fresh or salt) can significantly affect the pathophysiological changes seen in drowning. Fresh water causes a more rapid influx of water into the lungs, leading to hemorrhagic lung edema, whereas salt water leads to a slower influx of water and a different set of changes.

**Correct Answer: A**