April Jernigan is a 64-year-old teacher with a 10-year histo…

Questions

April Jernigаn is а 64-yeаr-оld teacher with a 10-year histоry оf chronic lung disease.  Despite advice from her doctor to quit smoking, Ms. Jernigan continues to smoke two packs of cigarettes a day.  She is admitted to the hospital with dyspnea, fatigue, and significant pedal edema.  She has a significant “smoker’s cough” and a specimen of sputum has been sent to the laboratory for analysis. Vital signs are 39.8C, 118, 26, 168/104. The following laboratory values are obtained:   Ms. Jernigan’s CBC reveals that she has likely developed which of the following?