Cf Fm Ch 19 Acute Bronchitis

Front 1

1. Next step in the treatment of Acute Bronchitis?

Back 1

1. Bronchodilators
2. Analgesics
3. Antitussives
4. Antibiotics have not been consistently shown to be beneficial
b. The illness is usually self-limited

Front 2

2. Common noninfectious causes of cough?

Back 2

a. Asthma
b. COPD
c. Malignancy
d. Postnasal drip
e. GERD
f. ACE inhibitor or other Medication side effects
g. Congestive heart failure

Front 3

3. Cause of most acute bronchitis?

Back 3

a. Viruses
b. Abx therapy is not helpful in most cases

Front 4

4. Tx of acute bronchitis?

Back 4

a. Pt is best tx’d w/bronchodilator therapy such as albuterol and antitussive agents
b. F/u in 2-3 wks

Front 5

5. Acute bronchitis?

Back 5

a. Inflammation of the tracheobronchial tree

Front 6

6. Pneumonia?

Back 6

a. Inflammation or infection of the lower respiratory tract, involving the distal bronchioles and alveoli.

Front 7

7. When does acute bronchitis most commonly occur?

Back 7

a. Winter.

Front 8

8. Causes of Acute Bronchitis?

Back 8

1. Influenza
2. Parainfluenza
3. Adenovirus
4. Rhinovirus
5. Mycoplasma pneumoniae
6. Chlamydia pneumoniae

Front 9

9. Most common presenting symptoms of acute bronchitis?

Back 9

a. Cough productive of purulent sputum

Front 10

10. Other symptoms of acute bronchitis?

Back 10

a. Fever
b. Malaise
c. Rhinorrhea or nasal congestion
d. Sore throat
e. Wheezing
f. Dyspnea
g. Chest pain
h. Myalgias/arthralgias

Front 11

11. PE w/Bronchitis?

Back 11

a. Typically nonspecific and is frequently normal
b. The presence of fever, tachypnea, tachycardia, and hypo-or hypertension should be noted in persons with underlying pulmonary cardiac conditions, or in persons with more severe symptoms, oxygen saturation by pulse oximetry may be warranted
c. Examination the lungs may reveal rales, rhonci, or wheezes but in most cases is a remarkable

Front 12

12. Conjunctivitis and adenopathy w/acute bronchitis suggest?

Back 12

a. Adenoviral infection, although these findings are nonspecific.

Front 13

13. What is the exception to the rule that abx do not alter the course of acute bronchitis?

Back 13

a. In the uncommon case of Bordetella pertussis.

Front 14

14. When should patients be evaluated further for the diagnosis?

Back 14

a. Abnormal vital signs (pulse ≥100 bpm)
b. Respirations ≥24 breaths/min
c. Temperature ≥100.4 (38C).
d. Examination findings consistent w/pulmonary consolidation should be evaluated further for the diagnosis of pneumonia and treated appropriately, if confirmed.

Front 15

15. Rhinosinusitis?

Back 15

a. Inflammation/infection of the nasal mucosa and one or more paranasal sinuses.
b. Sinusitis occurs with obstruction of the normal drainage mechanism
c. Is usually divided into acute, subacute, chronic, and acute exacerbation of chronic sinusitis

Front 16

16. Acute Rhinosinusitis duration?

Back 16

a. <4 weeks

Front 17

17. Subacute Rhinosinusitis duration?

Back 17

a. 4-12 weeks

Front 18

18. Chronic Rhinosinusitis duration?

Back 18

a. >12 weeks

Front 19

19. When in the diagnosis of bacterial Rhinosinusitis considered?

Back 19

a. When symptoms persist after 7 days in adults and after 10 days in children
b. Consider with:
1. The presence of purulent nasal discharge
2. Maxillary tooth or facial pain
3. Unilateral maxillary sinus tenderness
4. Worsening of symptoms after initial improvement

Front 20

20. What bacterial organisms are most common responsible for acute bacterial sinusitis in adults?

Back 20

a. Streptococcus pneumoniae
b. Haemophilus influenza

Front 21

21. What bacterial organisms are most common responsible for acute bacterial sinusitis in children?

Back 21

a. Streptococcus pneumoniae
b. Haemophilus influenza
c. Moraxella Catarrhalis

Front 22

22. Organisms seen in chronic sinusitis?

Back 22

a. The infecting organisms are variable, with a higher incidence of anaerobic organisms seen.
b. Ie Bacteroides
c. Peptostreptococcus
d. Fusobacterium

Front 23

23. Treatment of acute sinusitis?

Back 23

a. Should be directed at the likely causative agent
b. Amoxacillin and trimethoprim – sulfamethoxazole are widely used first-line agents, typically for 10 to 14 day regimens.
c. 2nd line agents, for those who fail to improve on initial regimen or who have recurrent or severe disease, include:
1. Amoxacillin – clavulanic acid (augmentin)
2. 2nd or 3rd generation cephalosporins
3. Fluoroquinolones
4. Second-generation macrolides: azithromycin, clarithromycin.

Front 24

24. Adjunctive therapy for acute sinusitis?

Back 24

a. Oral or topical decongestants may provides symptomatic relief
b. Topical decongestants should not be used for more than 3 days, to avoid the risk of rebound vasodilation with resultant worsening of symptoms

Front 25

25. Pharyngitis?

Back 25

a. Inflammation or irritation of the pharynx and/or tonsils
b. In adults, the vast majority of pharyngitis is viral!!!
c. Can also be bacterial or allergic
d. Other origin (rare causes )s:
1. Trauma
2. Toxins
3. Malignancy

Front 26

26. The incidence of pharyngitis in the pediatric population?

Back 26

a. 4 to 7 years old

Front 27

27. Common causes of pharyngitis in teens and young adults?

Back 27

1. Mycoplasma pneumoniae
2. Chlamydia pneumoniae
3. Arcanobacterium hemolyticus

Front 28

28. How prevalent is GAs pharyngitis?

Back 28

a. 15% of adults
b. 30% of pediatric cases

Front 29

29. Sore throat associated with cough and rhinorrhea is most likely?

Back 29

a. Viral in origin

Front 30

30. Findings associated with GAS infections?

Back 30

a. Abrupt onset of sore throat and fever
b. Tonsillar and/or palatal petechiae
c. Tender cervical adenopathy
d. Absence of cough