Chronic Bronchitis - Slocum

Question 1

Chronic bronchitis is defined by productive cough for _ months per year for _ consecutive years

Answer 1

3 months

2 years

Question 2

Pts are referred to as blue bloater, why?

Answer 2

Color indicative of hypoxia observed in bluish tint to skin and mucous membranes

Question 3

what are signs and symptoms?

Answer 3

• Minimal and nonspecific until advanced
• Productive cough
• Cyanosis
• mild dyspnea
• Hyperventilation
• swollen feet/ankle
• hemoptysis

Question 4

What are some physical findings ?

Answer 4

• Hypercarbail/hypoxia
• decreased breaths ounds
• Ronchi
• end expiratory wheezing
• barrel chested
• pursed lip breathing
• signs of pulm HTN (RVH, JVD, hepatomegaly)
• Peripheral edema

Question 5

What are some findings on ABG ?

Answer 5

• Hypoxemia –> decreased PO2

- acute or chronic respiratory acidosis –> increased PCO2

Question 6

What are some findings on CXR/

Answer 6

• decreased lung markings with falttened diaphragm
• hyperinflated lungs with bullae and/or blebs
• thin appearing heart and mediastinum
• barrel chest

Question 7

What findings are seen on lung biopsy

Answer 7

diagnostic gold standard

- increaed Reid index (gland layer >50% of total bronchial wall)

Question 8

What are PFTs findings

Answer 8

• Decreased FEV1/FVC
• Normal or decreased FVC
• Normal or increased TLC
• Roughly normal DLCO vs decreased DLCO in emphysema

Question 9

Treatment options

Answer 9

• O2, Beta agonist, anticholinergics, inhaled/IV steroids, antibiotics
• Acute exacerbation: inhaled Beta agonist; anticholinergics, IV and inhaled steroids, broad spectrum abx
• Smoking cessation, O2 if SaO2<89%, bronchodilators, steroids, pneumococcal and flu vaccines