Flashcards in Adult - Respiratory Deck (32):
What is the most likely cause of acute bronchitis?
rhinovirus, coronavirus, adenovirus
What are the signs and symptoms of acute bronchitis?
What is the significance of fever in acute bronchitis?
provides and important clue as to cause =
none or low grade --> viral
more pronounced --> bacterial
What are the lung sounds of acute bronchitis?
if rhonchi --> clear after pt directed to cough
What is the normal percussion tone of the chest?
What is the percussion tone of acute bronchitis?
therefore, no evidence of consolidation which would be seen in pneumonia
How is the diagnosis of acute bronchitis made?
usually by clinical picture
if concern about pneumonia, as in older adult --> CXR
What is the non pharm management of acute bronchitis?
What is the pharm management of acute bronchitis?
~ cough suppressants (judiciously)
If an antibiotic is warranted in acute bronchitis (significant fever, for example) which is a good choice?
o trimethoprim-sulfamethoxazole (Bactrim)
What does hyper-resonance indicate?
Is the diagnosis of acute bronchitis vs pneumonia easier in the younger adult or older?
younger is more clear cut
hence, more CXR in older adult to be sure
What type of mucus is associated with asthma?
thick, viscid mucous which leads to plugging of airways
What is pulsus paradoxus?
Drop in systolic BP during inspiration
What are some ominous signs of asthma? (5)
absent breath sounds
cyanosis - late sign in the adult
inability to maintain recumbency
paradoxical chest/abdomen movement
How are PFTs / peak flows used to determine need for hospitalization in the adult?
if FEV1 is < 30% of predicted or dose not increase to at least 40% after 1 hour of vigorous therapy
if peak flow is < 60 L/min initially or does not improve to > 50% of predicted after 1 hour of treatment
Which two conditions make up COPD?
characterized by excessive secretion of bronchial mucus and productive cough
at least 3 months in two consecutive years
abnormal, permanent enlargement of the alveoli
What is the typical picture of a patient with chronic bronchitis?
stocky or obese
normal chest A-P diameter
younger (onset after age 35)
copious, purulent sputum
What is the typical picture of a patient with emphysema?
increased chest A-P diameter
older (onset after age 50)
thin, spit-like sputum
progressive, constant dyspnea
Can people have features of both chronic bronchitis and emphysema?
What is the CXR finding of a patient with COPD?
low, flattened diaphragm
due to air trapping
Which PFT values are reduced in COPD?
F or Flow values - FEV1 FVC etc
Which PFT values may be increased in COPD?
C / capacity or V / volume values - TLC, FRC, RV
What is the mainstay of COPD management?
inhaled anticholinergics - ipratroprium bromide (Atrovent)
What is the most common causative organism in typical community acquired pneumonia in adults?
What are signs and symptoms of TYPICAL pneumonia? (5)
LUNG CONSOLIDATION (big diff from bronchitis)
What are signs and symptoms of ATYPICAL pneumonia?
ENT and URI symptoms + lung symptoms
~ soreness in chest
adventitious breath sounds
What are the most common causative organisms in atypical community acquired pneumonia in adults?
What are the CXR findings in community acquired pneumonia?