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22 Cards in this Set
- Front
- Back
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What is chronic bronchitis?
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Inflammatory disease of the airways
Cough and sputum expectoration on most days for at least 3 months of the year for at least 2 consecutive years |
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What are risk factors for chronic bronchitis?
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Smoking
Infection (viral/bacterial) Air pollution Occupational exposure (coal, cement, welding fumes, engine exhaust) |
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What are the hallmarks of chronic bronchitis?
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Chronic mucous hypersecretion
Cough |
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What does chronic bronchitis look like in the gross pathology?
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Brown discolored
Increased mucus production (mucus filled bronchi) |
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What is found in the histology of chronic bronchitis?
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Increased number of mucus glands
Goblet cell metaplasia Fibrosis of bronchioles Loss of cilia Bronchial smooth muscle hypertrophy |
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Why is chronic bronchitis an obstructive disease?
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Airway resistance due to mucus, edema, and narrowing
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What is emphysema?
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Dilation and destruction of air spaces distal to the terminal bronchiole to the alveoli
Alveoli lose elasticity, become overstretched and rupture |
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What does the pathology of emphysema look like?
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Hyperinflation of alveoli
Lung elasticity decreases |
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What is responsible for the V/Q mismatch in chronic bronchitis?
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Mucus plugging
Airway obstruction Hypoxemia |
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What is responsible for the V/Q mismatch in emphysema?
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Alveoli lose elastic recoil, then distend and blow out
Small airways collapse or narrow Air trapping Hyperinflation Decreased surface area for ventilation |
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What is seen in the early stages of CB?
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May ignore early symptoms
Symptoms progress slowly Productive cough ("smoker's cough") Bronchospasm Frequent respiratory infections |
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What is seen in advanced stages of CB?
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Dyspnea on exertion and then at rest
Hypoxemia and hypercapnia Polycythemia Cyanosis Clubbing Pursed lip breathing |
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What is seen in early stages of emphysema?
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Dyspnea
Non-productive cough Diaphragm flattens A-P diameter increases (barrel chest) |
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What is seen in advanced stages of emphysema?
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Hypercapnia
Purse-lip breathing Use of accessory muscles to breathe Underweight Lung sounds diminished |
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What are the goals of CB treatment?
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Improved ventilation
Remove secretions Prevent complications Slow progress of signs and symptoms |
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Why do you prescribe anti-inflammatory corticosteroids for CB?
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They may slow progression of airflow obstruction
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What is the purpose of prescribing beta-agonists for CB?
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Control bronchospasm
Relieve dyspnea |
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What two vaccinations must a person with CB receive?
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Influenza
Pneumococcal |
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What is essential for the physician to do if a patient has an acute exacerbation?
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Determine the cause- infections vs. non-infectious
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How do you diagnose acute exacerbations?
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One or more 3 cardinal symptoms
1. Worsening dyspnea 2. Increased sputum production 3. Increased sputum purulence |
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How do you treat acute exacerbation if only 1/3 cardinal symptoms?
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Rest
Fluids Symptomatic treatment- bronchodilators |
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How do you treat acute exacerbation if 2/3 cardinal symptoms?
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Empiric antibiotic therapy
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