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Comments ...

 +0  (nbme18#21)

uptodate says it can cause only osteolytic lesions too, and because it says "most likely" and breast cancer is the most common cancer in women, it is breast ...

 +0  (nbme18#34)

the radiation therapy caused fibrosis and the myofibroblasts "contract" during fibrosis, causing the closure of airways and thus atelectasis

 +0  (nbme18#27)

chronic bronchitis causes squamous metaplasia of the pseudostratified columnar epithelium in the bronchi and bronchioles

---- these columnar epithelium normally contribute to the mucociliary clearance and smoking also damages this clearance, so can get the clue from that too

Subcomments ...

submitted by lamhtu(27),

Stem should maybe say some lesions are lytic and some are sclerotic. Breast mets to bone is mixed type according to FA? If you go off the mets being purely lytic, one could think thyroid carcinoma is the correct primary tumor.

lae  thats also what I thought +  

submitted by ergogenic22(42),

I believe that the question is suggesting the patient has a methanol overdose.

First Aid 2018 page 72: "FOMEpizole—inhibits alcohol dehydrogenase and is an antidote For Overdoses of Methanol or Ethylene glycol."

The reason I am unsure is that wikipedia states most paint thinners are ketones or hydrocarbons

lae  that's correct, I don't know about what the thinner has but the clinics is methanol toxicity for sure +