chief Complaint: 40-year-old man with a cough and dyspnea.History: Joe Butt, a 40-year-old white male with a 52-pack-yearsmoking history suffered from chronic bronchitis. For the lastseveral months he has been on an antibiotics treatment. Three weeksago, his otherwise normal smoker’s cough started producing bloodysputum (\"hemoptysis\"). In the past week Joe has become increasinglyshort of breath (\"dyspnea\"). A routine chest X-ray revealed acouple of quarter-sized opacities in his right lung around thealveoli. Bronchoscopic examination revealed the tumors were nearlyoccluding two major bronchioles in his right lung. A bronchialbiopsy revealed the diagnosis: bronchogenic carcinoma. Questions:1. What is \"bronchogenic carcinoma\"? What medical professional mostlikely confirmed the nature of the biopsy? 2. Describe thestructure of the bronchial epithelium. How many layers of cellsmake up this tissue? 3. Describe what the “mucociliary escalator\"is and it’s function in the respiratory system. 4. What twoconditions do you think have led to Joe experiencing a shortness ofbreath (\"dyspnea\")? 5. What is the most likely or common way thatthis type of cancer may metastasize (i.e. spreading to other partsof the body)?
