Upper Respiratory Infection/ Bronchitis Flashcards
Essentials of Diagnosis for what?
(1) Clear rhinorrhea, hyposmia, and nasal congestion
(2) Associated Symptoms: Malaise, headache, and cough
(3) Erythematous, engorged nasal mucosa on examination without intranasal purulence.
(4) Symptoms last <4 weeks and typically < 10 days
(5) Symptoms are self-limited.
Upper Respiratory Infection
URI is also called what?
Common cold
True/False
Common cold is not the most frequent acute illness in the United States and throughout the industrialized world.
False,
Most common
_____ benign, self-limited syndrome representing a group of diseases caused by members of several families of viruses.
Common Cold/ URI
The most common and characteristic initial symptoms are ______, _______, ______
Cough is common and tends to appear after
the onset of _________
nasal discharge
nasal obstruction
dry or “scratchy throat”.
nasal discharge and obstruction
Colds usually persist for ______ in the normal host, although clinical illness may last as long as ______ in up to 25 percent of patients, particularly smokers.
3 to 10 days
two weeks
How long is the incubation period for URI
24 to 72 hours
10-12 in an experimental setting
What are some DDxs for URI
(1) Bronchitis
(2) Pneumonia
(3) Allergic or seasonal rhinitis
(4) Pertussis
5) Influenza
(6) Aspiration
Are labs indicated for URI?
no
The ________ is a separate and distinct entity, distinguishable from influenza, bacterial pharyngitis, acute bronchitis, acute bacterial sinusitis, allergic rhinitis, and pertussis.
common cold
What are the meds used to treat symptoms for URI
-Acetaminophen 325mg 1-2 tablets po q4-6h prn fever or pain
-Pseudoephedrine
-Immediate release: 60 mg every 4 to 6 hours
-extended release: 120 mg every 12 hours or 240 mg every 24 hours
-Oxymetazoline (Afrin) nasal
-12 Hour Nasal Relief Spray: 0.05% (15 mL, 30 mL), Intranasal: Instill 2 to 3 sprays into each nostril twice daily for 3 days
What are some adverse effects of Pseudoephedrine:
HTN, arrhythmias, insomnia, anxiety, palpitations
What is defined as inflammation of the tracheobronchial tree
Acute Bronchitis
Essentials of diagnosis for Bronchitis
Cough associated with midline burning chest pain, fever, and dyspnea
PT presents with these issues what would you suspect?
(1) Patients complain of cough, fever, and constitutional symptoms.
(a) Cough is initially dry but can become productive.
(b) Often associated with midline chest pain or burning.
(2) Hemoptysis, wheezing, and rales may be present.
(3) Rhonchi that clears with coughing is a characteristic finding.
(4) The presence of rales is more characteristic of pneumonic consolidation or other condition involving the pulmonary parenchyma.
(5) Cigarette smoking is a cause or contributing factor in many cases.
Bronchitis
True/False
Acute bronchitis and Pneumonia are common, and it can be difficult to differentiate
True
The primary clinical difference between bronchitis and pneumonia is ________ on the chest Xray
presence of an infiltrate in the case of pneumonia
For acute bronchitis, X-ray will usually show…..
no evidence of infiltrate
What are some DDx for Bronchitis
(1) Cardiac
(2) Pulmonary
(3) Trauma
(4) GI
(5) Musculoskeletal
(6) Psych
True/False
Acute bronchitis needs aggressive management
False
rarely needs aggressive management
What meds would you give for Bronchitis
-NSIADS
-Acetaminophen (Tylenol)
-325-1000 mg PO q 4-6 h, max 4 grams/24 h
Cough suppressants/Antitussives
-Benzonatate, 100-200mg TID
SABA
Albuterol MDI 2 - 4 puffs q4-6h prn.
_____ patients and those with significant underlying cardiopulmonary disease may
require close monitoring.
Hypoxic
Disposition for bronchitis
-Modified duty. 1-2 days SIQ or light duty as needed.
-Retain on board.
-Complications
-Chronic presentation
-Significant underlying comorbidity.
Supplemental oxygen should be administered to patients who are …..
Hypoxic
