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F2 E3 Shea > Acute Bronchitis & Pertussis > Flashcards

Acute Bronchitis & Pertussis Flashcards

1
Q

What is the pathophysiology of Acute Bronchitis?

A
  • self limited bronchial inflammation
  • associated with viral URI
  • Different from chronic bronchitis
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2
Q

What is the etiology of acute bronchitis?

A

VIRAL!

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3
Q

Which viruses cause Acute Bronchitis?

A
  • Influenza A & B
  • Parainfluenza
  • Coronavirus
  • Rhinovirus
  • Respiratory syncytial virus (RSV)

Acute Bronchitis is a “PRRIC”

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4
Q

T/F: Bacteria can cause Acute Bronchitis

A

TRUE

  • mycoplasma pneumoniae
  • chlamydophilia pneumoniae
  • Bordetella Pertissus

My Bronchitis is not Chronic

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5
Q

How will a patient with Acute Bronchitis present?

  • Cough lasting more than how long?
A
  • Cough lasting more than 5 days (usually 1-3 weeks)
    • +/- productive
  • Usually afebrile unless the viral cause of the bacteria is specifically influenza.
  • Febrile if bacterial cause
  • Chest wall tenderness
  • Wheezing
  • mild dyspnea
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6
Q

Physical Exam for Acute Bronchitis

  • 2 positive findings
  • 2 negative findings
A
  • Wheezing+
  • Rhonchi+ that clears w/coughing
  • Negative for rales- and signs of consolidation-
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7
Q

What diagnostics would you use for Acute Bronchitis?

A
  • WBC is normal to mildly elevated
  • CXR: normal or nonspecific, may not be needed
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8
Q

What is the management of Acute Bronchitis?

A

***Symptomatic Treatment***

  • Antitussives (codeine, dextromethorphan)?
  • B2 agonists If wheezing
  • OTC products: expectorants/mucolytics, antihistamines, decongestants
  • Corticosteroids
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9
Q

Main take home points of Acute Bronchitis

A
  • It is mainly VIRAL
  • Only 1% of patients have acute bronchitis caused by pertussis.
  • 60 - 90% are given abx, even though 99% are viral
  • Patient education: Be cautious when pts ask about antibiotics: ACUTE BRONCHITIS IS MAINLY CAUSED BY VIRUSES
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10
Q

What is “whooping cough”

A

Pertussis

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11
Q

What is the etiology of Pertussis?

A

Bordetella Pertussis

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12
Q

What is the pathology of Bordetella Pertussis?

A

Releases toxin that damages cilia and causes airways to swell

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13
Q

What age group is most likely to get Pertussis?

A

< 2 y/o

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14
Q

How is Bordetella Pertussis transmitted?

A
  • Respiratory droplets
  • Incubation 7-17 days
  • Contagious for 2 weeks after onset of cough
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15
Q

What is the incubation period of B. Pertussis?

A

7-17 days

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16
Q

Pts with B. Pertussis are contagious for _______ after onset of _______

A
  • 2 weeks
  • cough
17
Q

What is the clinical presentation of Pertussis?

A
  • Catarrhal: 1-2 wks
    • malaise, rhinorrhea, mild cough, mild fever
    • Lacrimation & conjunctival injection
  • Paroxysmal: begins in 2nd week & lasts 2-3 months
    • Paroxysmal cough: sudden bursts of rapid, consecutive coughs followed by deep, high-pitched inspiration (whoop)
    • +/- post-tussive syncope or emesis
  • Convalescent: 1-2 weeks
    • Gradual reduction frequency and severity of cough
18
Q

How long does the Catarrhal stage of Pertussis last and what symptoms are present?

A
  • 1-2 weeks
  • Malaise, rhinorrhea, mild cough, mild fever
  • lacrimation & conjunctival injection
19
Q
  • 1-2 weeks
  • Malaise, rhinorrhea, mild cough, mild fever
  • lacrimation & conjunctival injection

What stage of Pertussis is this?

20
Q
  • Begins in 2nd week & lasts 2-3 months
  • Cough: sudden bursts of rapid, consecutive coughs followed by deep, high-pitched inspiration (whoop)
  • +/- post-tussive syncope or emesis
A

Paroxysmal

21
Q

1-2 weeks

Gradual reduction in frequency and severity of cough

A

Convalescent

22
Q

What are diagnostics you want to run for Pertussis?

A
  • CBC: elevated blood count
  • Nasopharyngeal culture
  • PCR assay
23
Q

Pertussis Treatment

A

1st line: Azithromycin

2nd line:

Clarithromycin

Erythromycin

Trimethoprim-sulfamethoxazole (Bactrim)

24
Q

Pertussis Prevention

A

VACCINATION

All infants: DTaP

Adolescents age 11-18 y/o: Tdap booster

All adults: single Tdap dose

Pregnant women: Tdap with each pregnancy b/t 27-36 wks gestation; if not given during pregnancy, give immediately postpartum

Post-exposure prophylaxis: oral macrolide (or any of the other treatment regimens)

25
Q

Complications of Pertussis

A

**Most serious in babies/children

  • half of babies under 1 y/o need hospitalization

- Pneumonia, Otitis Media

Cough can lead to subconjunctival hemorrhage, abdominal wall hernia, rib fractures, urinary incontinence, lumbar strain

26
Q

4 Rare Complications of Pertussis

A
  • intracranial hemorrhage
  • stroke due to carotid or vertebral artery dissection
  • encephalopathy
  • seizures due to hypoxia

(ESSI)

F2 E3 Shea (16 decks)

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