Acute Bronchitis Flashcards

1
Q

Define acute bronchitis

A

Infection and Inflammation of the trachea and major bronchi (LRTI) but not of the lung parenchyma - oedematous large airways and production of spututm
Self limiting in nature - short term
Typically viral

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2
Q

What is the relevant epidemiology of acute bronchitis?

A

Peak 50-60yrs
Ten times more common than pnuemonia
80% of episodes occur in winter or autumn.

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3
Q

What are the typically symptoms of acute bronchitis?

A

Cough - may be productive
Sore throat
Rhinorrhoea
Wheeze
May also have a low grade fever

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4
Q

How does acute bronchitis appear on examination?

A

Patient may have a normal chest examination
Wheeze
Rhonchi - snoring like sound cleared on coughing
Prolonged expiration - due to bronchial obstruction

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5
Q

What investigations should be done for acute bronchitis?

A

Is typically a clinical diagnosis
However, if CRP testing is available this could be used to determine if antibiotics are needed.

Bedsice - resp viral swab, spututm culture
Bloods - CRP
Imaging - CXR (rule out pneumonia)

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6
Q

What are some key ways to differentiate between acute bronchitis and pneumonia?

A

History - wheeze, sputum and breathlessness - more common in pneumonia
Exam - no focal chest signs (dullness, crepitation, bronchial breathing) in bronchitis.
Pneumonia has more systemic features - malaise, myalgia and fever

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7
Q

How is acute bronchitis managed conservatively?

A

Good fluid intake
Reassurance and safety netting - seek medical help is worsen or not improved in 3/4w
Self care - lozenges or honey
Advise smoking cessation

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8
Q

At what CRP values should antibiotics be offered for acute bronchitis?

A

20-100mg/L offer a delayed prescription
>100mg/L offer immediateley

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9
Q

What is the prognosis for acute bronchitis?

A

Usually resolves before 3 weeks
However 25% of patients will still have a cough beyond this time.
Recurrence is common especially in patients who smoke

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10
Q

What are the risk factors for acute bronchitis?

A

Smoking
Age - very young or very old
Lung disease - COPD or asthma
Exposure to infections - COVID-19 or flu
Irritants - dust, fumes, air pollution or tobacco smoke
Malnutrition
Reflux - irritate throad and increase risk

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11
Q

What are the common causes of acute bronchitis?

A

Mjaority are viral - rhinovirus, coronavirus, adenovirus
Bacteria may cause up to 10% of cases - streptococcus pneumonia, H.Influenza, Moraxella catarrhalis.

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12
Q

How is acute bronchitis managed medically?

A

Analgesia - paracetamol

Consider antibiotics is systemically unwell, pre-exisintg co-morbidities, dependent on CRP value.

First line - doxycycline 5/7(not in children or pregnant women) alternative is amoxicillin.

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13
Q

What are some complications of acute bronchitis?

A

Pneumonia - esp in vulnerable, edlerly, frail or immunosuppressed
Persistent cough - over a month in 25%, up to 6m in ‘post bronchitis syndrome’

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