Acute Bronchitis & CAP Flashcards
a lower respiratory tract infection involving the bronchi, mostly caused by a viral infection
acute bronchitis
what is acute bronchitis preceded by?
URI
how does a cough present in a patient with acute bronchitis? (3)
5-18 days
rhonchi that clears with cough
chest pain
how is a clinical diagnosis of acute bronchitis made?
by exclusion of pneumonia
what test can be ordered for acute bronchitis?
rapid test for flu and COVID
how long does acute bronchitis take to resolve on its own?
1-3 weeks
what is the general treatment for acute bronchitis?
cough suppressant
NSAIDs
what cough suppressants can be used for acute bronchitis?
benzonatate
dextromethorphan
what NSAIDs can be used for acute bronchitis?
ibuprofen
naproxen
where does pneumonia take place in the lungs?
alveoli
what is the most common cause of CAP?
aspiration from oropharynx
what is the most common organism of CAP?
strep pneumoniae
a patient presents with fever, rigors, pleuritic chest pain, hemoptysis, abdominal pain, tachypnea, tachycardia inspiratory crackles or bronchial breath sounds, dullness to percussion. what are they experiencing?
CAP
what would CAP look like in a chest xray? (2)
patchy airspace opacities
pleural effusion
what other diagnostics, besides chest xray, can be done for CAP? (2)
sputum gram stain
urinary antigen test
what are 3 indications for urinary antigen testing for S. pneumonia?
leukopenia
alcohol use
asplenia
what are 3 indications for urinary antigen testing for Legionella?
recent travel
alcohol use
hyponatremia
what is the treatment for CAP for an otherwise healthy patient?
amoxicillin + azithromycin OR doxycycline
what is the treatment for CAP for a patient who has comorbidities or has used antibiotics recently?
Augmentin + azithromycin OR doxycycline
what is the treatment for CAP in a patient that is allergic to penicillin?
cephalosporin + azithromycin OR doxycycline
what is the treatment for a patient that has structural lung disease?
levofloxacin
moxifloxacin
lefamulin
what class of medication can be added for a patient with severe CAP and is hospitalized?
corticosteroids
what is used to determine whether a patient with CAP should be admitted to the hospital?
Pneumonia Severity Index (PSI)
CURB-65
how long will a chest xray take to clear after successful treatment of CAP?
over 6 weeks
what are 2 clues that CAP etiology is legionella?
recent travel
low Na+
what are 2 clues that CAP etiology is strep pneumonia?
rust colored sputum
crowded area
what is a clue that CAP etiology is h. influenza?
COPD
what is a clue that CAP etiology is m. catarrhalis?
COPD
what are 2 clues that CAP etiology is Klebsiella pneumonia?
solid organ transplant
dialysis
what are 2 clues that CAP etiology is anaerobic?
peridontal disease
foul smelling sputum
what is a clue that CAP etiology is mycoplasma pneumonia?
bullous myringitis (bubbles in ear)
what is a clue that CAP etiology is histoplasmosis?
exposure to bat/bird droppings
what is a clue that CAP etiology is hantavirus?
exposure to mouse droppings