Acute bronchitis

Question 1

acute bronchitis will have

Answer 1

cough, and upper airway secretions

SHOULD NOT HAVE infiltrates on CXR, focal rales or rhonchi on physical exam. Need to rule out PNA

Question 2

Treatment of bronchitis

Answer 2

supportive.

those who have wheezing disturbing sleep or limit ADLS should have an albuterol inhaler for a short period of time.

Do not recommend abx, cough suppressants, or antihistamines or nasal decongestants

Question 3

acute bacterial rhinosinusitis tx

Answer 3

see purulent nasal discharge.

No Abx unless >10 days or they have bacterial sinusitis with fever>39, purulent nasal discharge, sinus tenderness, and most sinus infections resolve spontaneously.

Question 4

causes of subacute or chronic cough

Answer 4

post nasal drip (allergic or non allergic)
GERD
asthma
medications (ACE inhibitors)
Laryngopharyngeal reflux
atypical infections (pertussis)
bronchiectasis
lung cancer

Question 5

acute bronchitis due to

Answer 5

lower respiratory infection with viral upper resp infection

Question 6

bronchitis cough is

Answer 6

persistent cough lasting >5 days for up to 3 weeks

see hyperreactive airways with cough and obstructive evidence on PFTs for up to 5-6 weeks

Question 7

treatment of acute bronchitis is

Answer 7

inhaled beta 2 adrenergic agonist if symptomatic

Question 8

for acute bronchitis do we ever give antibiotics?

what if they have bacteria like mycoplasma or chlamydia pneumoniae?

Answer 8

no don’t give antibiotics even if they test positive for bacterial respiratory pathogens as evidence doesn’t show that antibiotics provide any benefit.

Question 9

if someone has acute bronchitis, when to get CXR to screen for pneumonia?

Answer 9

if there’s any suggestion of pneumonia (abnormal vital signs, hypoxemia, evidence of lung consolidation on exam)