A 75-year-old man lives at home with his wife and is inrelatively good health aside from hypertension and milddiabetes mellitus type 2. Through medications and lifestyle,the man is able to keep both of his medical conditionsunder control. He has never used tobacco, but his wifewas a smoker for 35 years. She quit approximately20 years ago. She always smoked in the house and inthe car with other family members present, including herhusband.The man presented with a 3-day history of fatigue, chills,and lack of appetite. He has no acute respiratory complaintsother than mild dyspnea and a fever of 101°F. On an almostdaily basis he coughs up yellow sputum (Figure 14-8) in themorning and has for several years. He has attributed thisto his “old age” and has never discussed this with hisphysician.
Laboratory ResultsPatient was found to have an elevated white blood countof 16,000 with more than 10 bands per high power field (hpf)
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Questions1. What risk factors are associated with this individual’s condition that predispose him to bacterial infections?2. Review the laboratory results provided. Identify the abnormalresults, and provide an explanation for recommendedfollow-up laboratory tests and any other recommendeddiagnostics.3. Review the Gram stain provided from the patient’s sputum.Is it stain consistent with the patient’s condition? What, ifany, additional tests would be recommended?