You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A 60 years old chronic smoker presents with complaints of hemoptysis. Her chest X-ray appears to be normal. What is the next best investigation: and explain in detail?
Answer is A (Bronchoscopy) : The patient presents a case of hemoptysis with normal X-ray but with risk factors for cancer (Age and history of smoking). Bronchoscopy together with a bronchial or transbronchial biopy is the investigation of choice as indicated in the following algorithm from harrisons text. Algorithm in Harrisons 16th/208 does not elaborate the distinction between bronchoscopy and HC and thus reference to previous editions is recommended.