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Clinical Medicine > Acute Bronchitis > Flashcards

Acute Bronchitis Flashcards

1
Q

What is another term for acute bronchitis

A

Tracheobronchitis
*lower respiratory tract infecon

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2
Q

What is acute bronchitis

A
  1. Acute inflammation of the trachea and bronchi
    *self limited
    *diagnosed clinically
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3
Q

What usually causes acute bronchitis

A

Viral etiology (85 to 95% of cases)
*definitive cause is unknown

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4
Q

What can help providers determine the source of the pathogen

A
  1. Presence of epidemics
  2. Time of year
  3. Populations vaccination status
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5
Q

Do people usually receive ATB for their acute bronchitis

A

Yes
*do not give ATB bc it is usually viral in nature
*giving ATB will lead to resistance

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6
Q

When is there a higher occurrence of acute bronchitis

A
  1. Late fall and winter
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7
Q

What are the viral causes of AB (90% off all cases)

A
  1. Adenovirus
  2. Influenza A B
  3. Parainfluenza
  4. Coronavirus type 1 and #
  5. Rhinovirus
  6. RSV
  7. Human metapneumovirus
  8. COVID-19
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8
Q

What are the bacterial causes of AB (Only 10% of the cases)

A
  1. Streptococcus pneumonia
  2. Haemophilus influenza
  3. Moraxella catarrhalis
  4. Bordetella pertussis
  5. Mycoplasma pneumonia
  6. Chlamydia pneumoniae
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9
Q

What patient population usually has a bacterial cause of AB

A
  1. Patients who have co-morbidities
    *AB caused by bacterial is rare in heathy adults
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10
Q

What is the cardinal symptom of AB

A
  1. Non productive or productive cough greater than a week (min 5 days)
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11
Q

What are some other symptoms of AB

A
  1. Mild fever
  2. Malaise
  3. Fatigue
  4. Wheezing
  5. Dyspnea
  6. Nasal congestion
  7. Sore throat
  8. Chest wall tenderness (muscle strain from coughing)
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12
Q

What will be on the PE of a patient with AB

A
  1. Wheezing and rhonchi may be present
  2. No consolidation or rales
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13
Q

What are some other clinical manifestations of AB

A
  1. Purulent sputum
    *reported in 50% of patients with AB
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14
Q

Why does purulent sputum occur in AB

A
  1. Sloughing of cells from the tracheobronchial epithelium along with inflammatory cells
  2. Purulent sputum in a suspected AB case does NOT signify bacterial infection and the need for ATB
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15
Q

What should you keep in mind when a patient has Ssx of URI/VR or AB

A
  1. You may not be able to distinguish from URI/RV From AB in the first few days
    *high possibility when the cough persists over >5 days, no improvement or worsening (AB)
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16
Q

What are the DDx of AB

A
  1. Pneumonia
  2. PND
  3. GERD
  4. Asthma
  5. ACE inhibitor use
  6. Heart failure
  7. Lung cancer
17
Q

What are some scenarios where it is not AB

A
  1. Patient presents with severe cough, fever, sputum production and other significant constitutional symptoms (flu or pneumonia)
  2. PE has signs of parenchyma consolidation or pleural inflammation (pulmonary disease beyond the bronchi)
18
Q

How to make the diagnosis for AB

A
  1. Can be made solely asked on the H &P
    *further testing is not needed
19
Q

When can ATB be used for AB

A
  1. Only in patients with highly suspected bacterial pathogens or immunocompromised, elderly, COPD, those unresponsive patients
  2. paroxysm of cough with an inspiratory whoop
    *first line is macrolides (Emycin, clarithromycin, Azithromycin)
20
Q

Do antihistamines work against AB

A
  1. Weak or no evidence
21
Q

Can inhaled corticosteroids work for AB

A
  1. Can be used if wheezing is present, but typically not used
22
Q

What are some symptomatic treatment (supportive care) options for AB

A
  1. Cough suppressants
    *throat lozenges, hot tea, honey
  2. Mucolytics (helps break down mucous component)
  3. Acetaminophen, ibuprofen
  4. Cough drops
  5. Rest, fluids
23
Q

What are some things to avoid with AB

A
  1. Avid dairy products, ETOH, caffeine (make the sputum thicker)
  2. Avoid exposure to smoke, air pollutants
24
Q

What are some red flags to watch out for with AB

A
  1. Coughing up blood
  2. Difficult swallowing

Clinical Medicine (164 decks)

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