1. A 45-year-old male with a 30-year history of smoking presents with a chronic cough and wheezing. A biopsy of the bronchial tissue reveals replacement of the normal pseudostratified columnar ciliated epithelium with stratified squamous epithelium. This change is best described as: 

Question 1 of 4

2. A 60-year-old female with a history of gastroesophageal reflux disease (GERD) undergoes endoscopy for evaluation of her symptoms. Biopsy of the lower esophagus shows replacement of the normal stratified squamous epithelium with columnar epithelium. This finding is indicative of: 

Question 2 of 4

3. During a routine pelvic examination, a 52-year-old postmenopausal woman is found to have a cervical lesion. Biopsy of the lesion reveals squamous metaplasia. Which of the following factors is most likely responsible for this finding? 

Question 3 of 4

4. A 65-year-old male with a long-standing history of smoking and chronic obstructive pulmonary disease (COPD) presents for evaluation of a new cough. A CT scan reveals a mass in the right lung, and a biopsy is performed. Histological examination shows areas of squamous metaplasia. This finding suggests that the patient's lung tissue has undergone which of the following processes? 

Question 4 of 4


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