Baby developed RDS --> guven O2 as Rx --> complications of O2 herapy in neonated = RIB (FA 2019) R = Retinopathy of prematurity I = Inraventricular hemorrhage B = Bronchopulmonary dysplasia

This infant has oxygen toxicity due to free radical generation. Free radicals damage the lung parenchyma leading to fibrosis and dysplasia (abnormal growth).

I think this is much simpler and is testing the understanding of basic path concepts of metaplasia and dysplasia. The question stem says there is bronchiolar metaplasia, and dysplasia is a reversible state of cells caused by longstanding hyperplasia or metaplasia (here in this case the baby presents 1 month later after the initial biopsy)

Per American Lung Association: Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease that affects newborns (mostly premature) and infants. It results from damage to the lungs caused by mechanical ventilation (respirator) and long-term use of oxygen. Most infants recover from BPD, but some may have long-term breathing difficulty. + Prematurely born infants have very few tiny air sacs (alveoli) at birth. The alveoli that are present tend to not be mature enough to function normal, and the infant requires respiratory support to breathe. Although life-saving, these treatments can also cause lung damage