Chapter·PathologyPulmonary

Pulmonary infectionsDownloads

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1

A 45-year-old male alcoholic presents with fever, productive cough, and foul-smelling sputum for the past two weeks. Vital signs are T 38.3 C, HR 106, BP 118/64 and RR 16. Oxygen saturation on room air is 90%. Given a diagnosis of aspiration pneumonia, initial chest radiograph findings would most likely include:

AMediastinal abscess located between vertebral levels T1-T3

BLeft lung abscess due to increased ventilation-perfusion ratio of the left lung

CRight lung abscess due to the right main bronchus being wider and more vertically oriented

DRight lung abscess due to increased anterior-posterior diameter of the right lung

ELeft lung abscess due to the left main bronchus being located superior to the right main bronchus

2

A 50-year-old man with a remote history of intravenous drug use and a past medical history of AIDS presents to his primary care provider with several weeks of productive cough and a mild fever. He was in his normal state of health and slowly started to develop these symptoms. He is hoping to be prescribed an antibiotic so he can get back to “normal”. Family history is significant for cardiovascular disease and diabetes. He takes antiviral medication and a multivitamin daily. His heart rate is 90/min, respiratory rate is 19/min, blood pressure is 135/85 mm Hg, and temperature is 38.3°C (100.9°F). On physical examination, he looks uncomfortable. A chest examination reveals consolidation in the right lower lung. Chest radiography confirms right lower lobe pneumonia. Of the following options, which is the most likely cause of the patient’s pneumonia?

APulmonary sequestration

BPneumocystis pneumonia

CAspiration pneumonia

DCommunity-acquired pneumonia

EDisseminated cutaneous infection

3

A 32-year-old man comes to the physician because of a 3-week history of cough, weight loss, and night sweats. He migrated from Sri Lanka 6 months ago. He appears emaciated. His temperature is 38.1°C (100.5°F). Physical examination shows enlargement of the right supraclavicular lymph node. Chest and abdominal examination show no abnormalities. An interferon-gamma assay is positive. A biopsy specimen of the cervical lymph node is most likely to show the causal organism in which of the following locations?

AMantle zone

BMedullary sinus

CGerminal center

DSubcapsular sinus

EParacortex

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