EH is a 68-year-old male who comes into the clinic complaining of a fever with a temperature of 103 °F. He has had a cough for the last three days that is producing some thick green brown mucous. The MD feels he most likely has bacterial pneumonia. He also has a history of having rheumatoid arthritis, and being immune compromised as he is on an immunosuppressant methotrexate. He has noted that over the last year he has lost weight unintentionally and feels he is underweight. 1. Understanding epidemiologic concepts of the chain of transmission of organisms from host to victim, describe how EH could have been infected. * Pneumonia is refers to an infection in the lungs that causes swelling in the lungs tissue and this inflammation will cause fluid to collect in or around the sac of the lungs. Mostly, weakened defenses will allow bacteria to multiply in the lungs, and the most common that can cause pneumonia is Streptococcus. Pneumonia can spread when the infected person sneezes, coughs, and when inflected person touches an objective with out washing his/her hands. 2. Describe the epithelial barriers that were overcome by EH’s bacteria.

3. With each of the following risk factors, put EH at risk for getting a bacterial pneumonia.
The risk factor of getting bacterial pneumonia that increase is

4. After looking at each of the risk factors, list three things that you would suggest to EH to help prevent infections in the future.

KH is a 67-year-old African-American man with primary hypertension and diabetes mellitus. He is currently taking an angiotensin-converting enzyme (ACE) inhibitor and following a salt-restricted weight loss diet. He is about 30 pounds over his ideal weight. At his clinic visit his blood pressure is noted to be 135/96. His heart rate is 70 beats/min. He has no complaints. His wife brought a blood pressure cuff and