Lower respiratory tract infections

•Sputum specimen sent for culture is considered good quality if it contains:

• Pus cells <5/low power field and epithelial cells >25/low power field

• Pus cells >25/low power field and epithelial cells <5/low power field

• Pus cells >25/low power field and epithelial cells >25/low power field

• Pus cells <5/low power field and epithelial cells <5/low power field

A sputum sample was brought to the laboratory for analysis. Gram •stain revealed the following: rare epithelial cells, 8 to 10 polymorphonuclear leukocytes per high-power field, and pleomorphic Gram-negative rods. As the laboratory consultant, which of the following interpretations should you make?

• The sputum specimen is too contaminated by saliva to be useful

• There is no evidence of an inflammatory response

• The patient has pneumococcal pneumonia

• The patient has Vincent’s disease

• The appearance of the sputum is suggestive of Haemophilus pneumonia

A 21-year-old college student complained of malaise, low-grade fever, and a harsh cough, but not of muscle aches and pains. An x-ray revealed a diffuse interstitial pneumonia in the left lobes of the lung. The WBC count

was normal. The student has been ill for a week. Based on the information given, the most likely diagnosis is

• Mycoplasma pneumonia

• Pneumococcal pneumonia

• Staphylococcal pneumonia

• Influenza

A man with chills, fever, and headache is thought to have “atypical” pneumonia. History reveals that he raises chickens and that approximately 2 weeks ago he lost a large number of them to an undiagnosed disease. The

most likely diagnosis of this man’s condition is

• Anthrax

• Q fever

• Leptospirosis

• Ornithosis (psittacosis)

Clinical-pulmonary infection score (CPIS) is used for:

• Ventilator-associated pneumonia

• Upper respiratory tract infections

• Community-associated pneumonia

• Tuberculosis

•CURB65 score is used for:

• Ventilator-associated pneumonia

• Upper respiratory tract infections

• Community-associated pneumonia

• Tuberculosis