Bronchiolitis and Viral Pneumonia

Question 1

What 3 things make up the “mucociliary elevator”?

Answer 1

1. Mucous membrane
2. Ciliated epithelial cells
3. Alveolar macrophages

Question 2

A patient comes in with 1 week history of dyspnea, cough, and purulent sputum. Upon ascultation you hear no rales, and scattered wheezes. Temp is 38 degrees C.

What is your diagnosis?

Answer 2

• Acute Bronchitis… an acute inflammation of the tracheobronchial tree.
• It is self-limiting
• We do not think pneumonia because there are no rales! The lungs are fine! And there is no major fever.

Question 3

What are the 3 main causes of acute bronchitis and what can they be associated with?

Answer 3

1. Influenza (sudden onset, fever, cough, headache)
2. Parainfluenza (epidemic; nursing homes)
3. RSV (you have an infant)

Question 4

What are the clinical manifestations and clues for diagnosis of acute bronchitis?

Answer 4

1. Productive cough
2. +/- Fever
3. Wheezing
4. Dyspnea
5. Myalgia
6. You do not have to do a chest x-ray. Absence of lung sounds is suffienct.

Question 5

What is the most common lower respiratory infection in infants (1-24 months) and what is it caused by?

Answer 5

1. Bronchiolitis - inflammation of the bronchioles
2. Respiratory Syncytial Virus (RSV)
3. Often associated with smoke exposure

Question 6

What are the clinical manifestations of Bronchiolitis and what is its major complication?

Answer 6

1. Runny nose
2. Sneezing
3. Low grade fever
4. Dyspnea
5. Wheezing
6. Major complication: bronchiolitis obliterans

Question 7

What are the main causes of viral pneumonia that we talked about and what type of patients are most susceptible?

Answer 7

1. Hantavirus
2. Influenza
3. Parainfluenza
4. Rhinovirus
5. Coronavirus (SARS)
6. Adenovirus
7. Cytomegalovirus
8. children and immunocompromised

Question 8

What viral source of pneumonia would you suspect in someone who just came back from camping in the woods?

Answer 8

Hantavirus - mouse droppings

Question 9

What viral source of pneumonia would you suspect with someone who just got back from Asia?

Answer 9

Coronavirus (SARS)

Question 10

What source of viral pneumonia wouls you suspect in someone who just got back from summer camp and has pink eye?

Answer 10

Adenovirus

Question 11

What viral source of pneumonia would you suspect for someone who is a recent military recruit?

Answer 11

Adenovirus

Question 12

What virual source of pneumonia would you suspect with someone who is immunocompromised because he just had a kidney transplant?

Answer 12

Cytomegalovirus