Acute Bronchitis and Pneumonia Overview

<p>Fever, dry cough, and shortness of breath (C)</p> Signup and view all the answers

<p>Antibody test (B)</p> Signup and view all the answers

<p>Hypokalemia (D)</p> Signup and view all the answers

<p>Mild productive cough (C)</p> Signup and view all the answers

<p>Symptoms lasting more than 3 weeks despite symptomatic treatment (B)</p> Signup and view all the answers

<p>1 to 3 weeks (C)</p> Signup and view all the answers

<p>Streptococcus pneumoniae (B)</p> Signup and view all the answers

<p>Viral infection (A)</p> Signup and view all the answers

<p>Crackles/rales that do not clear with cough (A)</p> Signup and view all the answers

<p>Persistent cough, often affecting sleep (A)</p> Signup and view all the answers

<p>Green-rust colored sputum (A)</p> Signup and view all the answers

<p>Acute Bronchitis (D)</p> Signup and view all the answers

<p>Mycoplasma pneumoniae (D)</p> Signup and view all the answers

<p>High fever (B)</p> Signup and view all the answers

<p>Hemophilus influenzae type B (C)</p> Signup and view all the answers

<p>Mycoplasma pneumoniae (C)</p> Signup and view all the answers

<p>Rhinorrhea (C)</p> Signup and view all the answers

<p>Adults older than 50 years old (A)</p> Signup and view all the answers

<p>Clear breath sounds (D)</p> Signup and view all the answers

<p>When there is suspicion of community-acquired pneumonia (CAP) (D)</p> Signup and view all the answers

<p>Bronchiolitis (A)</p> Signup and view all the answers

<p>Antibiotics for cough (B)</p> Signup and view all the answers

<p>Albuterol (A)</p> Signup and view all the answers

<p>Temperature &gt; 100.4, RR &gt; 24, HR &gt; 100 (B)</p> Signup and view all the answers

<p>For bacterial infections such as pertussis (D)</p> Signup and view all the answers

<p>Acute Bronchitis (B)</p> Signup and view all the answers

<p>Gradual onset with a dry, nonproductive cough (B)</p> Signup and view all the answers

<p>Chest X-ray (CXR) (C)</p> Signup and view all the answers

<p>When the patient is hospitalized with suspected MRSA or P. aeruginosa (A)</p> Signup and view all the answers

<p>Lobar consolidation (A)</p> Signup and view all the answers

<p>Azithromycin (C)</p> Signup and view all the answers

<p>Pleuritic chest pain (D)</p> Signup and view all the answers

<p>3 weeks (21 days) (C)</p> Signup and view all the answers

<p>When the patient is hospitalized with CAP. (B)</p> Signup and view all the answers

<p>18 years (C)</p> Signup and view all the answers

<p>Bradycardia (B)</p> Signup and view all the answers

<p>2 weeks (C)</p> Signup and view all the answers

<p>Metronidazole (C)</p> Signup and view all the answers

<p>500 mg twice daily (A)</p> Signup and view all the answers

<p>Myocarditis and pericarditis (D)</p> Signup and view all the answers

<p>Macrolides (D)</p> Signup and view all the answers

<p>Chest X-Ray (B)</p> Signup and view all the answers

<p>Heart Failure (D)</p> Signup and view all the answers

<p>Pulmonary Embolism (D)</p> Signup and view all the answers

<p>Antibody Test (B)</p> Signup and view all the answers

<p>Tuberculosis (D)</p> Signup and view all the answers

<p>Initially dry, progressing to productive (C)</p> Signup and view all the answers

<p>Dry, nonproductive cough (C)</p> Signup and view all the answers

<p>It is most common in patients over 50 years old. (B)</p> Signup and view all the answers

<p>1 to 3 weeks (D)</p> Signup and view all the answers

<p>Mycoplasma pneumoniae (D)</p> Signup and view all the answers

<p>Chills (C)</p> Signup and view all the answers

<p>Persistent cough with normal vital signs (B)</p> Signup and view all the answers

<p>Lobar consolidation (A)</p> Signup and view all the answers

<p>5 days (A)</p> Signup and view all the answers

<p>Adenovirus (C)</p> Signup and view all the answers

<p>Dry cough (C)</p> Signup and view all the answers

<p>School-age children (A)</p> Signup and view all the answers

<p>Influenza A virus (A)</p> Signup and view all the answers

<p>Normal or slightly elevated white blood cell count (D)</p> Signup and view all the answers

<p>In cases of severe community-acquired pneumonia (D)</p> Signup and view all the answers

<p>Clear breath sounds (A)</p> Signup and view all the answers

<p>High fever with tachycardia and tachypnea (C)</p> Signup and view all the answers

<p>More than 7 days (A)</p> Signup and view all the answers

<p>Macrolides (A)</p> Signup and view all the answers

<p>Possibility of pneumonia (D)</p> Signup and view all the answers

<p>Asthma (C)</p> Signup and view all the answers

<p>Increased fluid intake (B)</p> Signup and view all the answers

<p>Cough must occur daily for 3 months over 2 years (C)</p> Signup and view all the answers

<p>Progressive dyspnea (A)</p> Signup and view all the answers

<p>Streptococcus pneumoniae (A)</p> Signup and view all the answers

<p>Identification of causative agent (A)</p> Signup and view all the answers

<p>Atypical pneumonia (B)</p> Signup and view all the answers

<p>Green-rust colored sputum (D)</p> Signup and view all the answers

<p>Crackles that do not clear with cough (C)</p> Signup and view all the answers

<p>Symptoms persist for more than 3 weeks (B)</p> Signup and view all the answers

<p>Chronic obstructive pulmonary disease (COPD) (D)</p> Signup and view all the answers

<p>12 years (B)</p> Signup and view all the answers

<p>2 weeks (B)</p> Signup and view all the answers

<p>Combination therapy of beta-lactam and doxycycline (C)</p> Signup and view all the answers

<p>Myocarditis and pericarditis (C)</p> Signup and view all the answers

<p>Macrolides or fluoroquinolones (C)</p> Signup and view all the answers

<p>Combination therapy of beta-lactam and azithromycin (D)</p> Signup and view all the answers

<p>No doses; single shot only (B)</p> Signup and view all the answers

<p>CURB-65 criteria (A)</p> Signup and view all the answers

<p>Loss of smell or taste (C)</p> Signup and view all the answers

<p>New onset dyspnea (D)</p> Signup and view all the answers

<p>Fever (D)</p> Signup and view all the answers

<p>The presence of viral genetic material or viral proteins (D)</p> Signup and view all the answers

<p>Hemoptysis (C)</p> Signup and view all the answers

<p>Dullness to percussion (B)</p> Signup and view all the answers

<p>Oxygen saturation &lt; 90% (B)</p> Signup and view all the answers

<p>Begins as dry and nonproductive, progressing to productive (B)</p> Signup and view all the answers

<p>High-grade fever (C)</p> Signup and view all the answers

<p>A chest X-ray (B)</p> Signup and view all the answers

<p>Chronic Bronchitis (C)</p> Signup and view all the answers

<p>No organisms detectable on gram stain (B)</p> Signup and view all the answers

<p>Influenza A and B viruses (D)</p> Signup and view all the answers

<p>Hypokalemia (C)</p> Signup and view all the answers

<p>Fever, cough, dyspnea, and crackles on auscultation (B)</p> Signup and view all the answers

<p>Cough with normal vital signs in the absence of tachypnea, tachycardia, crackles, and egophony. (C)</p> Signup and view all the answers

<p>Streptococcus pneumoniae (D)</p> Signup and view all the answers

<p>When the patient has a significant increase in the production of thick colored sputum. (B)</p> Signup and view all the answers

<p>Persistent fever (T&gt;100.4), tachypnea, and new onset of altered mental status (B)</p> Signup and view all the answers

<p>High grade fever (B)</p> Signup and view all the answers

<p>Produce a burning, substernal pain with inspiration (C)</p> Signup and view all the answers

<p>Egophony present on chest exam (B)</p> Signup and view all the answers

<p>Greater than 10 mcg/dl (C)</p> Signup and view all the answers

<p>Acute bronchitis (C)</p> Signup and view all the answers

<p>Supportive care: humidifiers and increased fluid intake (D)</p> Signup and view all the answers

<p>When the patient has a history of asthma and presents with wheezing (C)</p> Signup and view all the answers

<p>Pertussis (D)</p> Signup and view all the answers

<p>Order an immediate chest x-ray for suspected community acquired pneumonia (CAP) (D)</p> Signup and view all the answers

<p>When the cough is severe and interfering with sleep or daily activities per PRN (B)</p> Signup and view all the answers

<p>Bilateral patchy alveolar densities (D)</p> Signup and view all the answers

<p>Mycoplasma pneumoniae (D)</p> Signup and view all the answers

<p>Azithromycin 500mg on the first day, followed by 250mg daily for 4 days (D)</p> Signup and view all the answers

<p>When P. aeruginosa or MRSA are suspected as causative agents (B)</p> Signup and view all the answers

<p>When a patient is hospitalized with CAP, MRSA or P. aeruginosa, or a patient who got parenteral antibiotics in last 90 days (C)</p> Signup and view all the answers

<p>Bacterial pneumonia caused by gram-negative bacteria (C)</p> Signup and view all the answers

<p>Maculopapular Eruptions (A)</p> Signup and view all the answers

<p>Chest X-Ray (CXR) (C)</p> Signup and view all the answers

<p>4 weeks (28 days) (B)</p> Signup and view all the answers

<p>2 weeks after the shot (B)</p> Signup and view all the answers

<p>Amoxicillin 1 gram TID plus doxycycline 100 mg BID (C)</p> Signup and view all the answers

<p>Azithromycin (B)</p> Signup and view all the answers

<p>12 years old (C)</p> Signup and view all the answers

<p>Myocarditis and Pericarditis (B)</p> Signup and view all the answers

<p>CURB-65 criteria and Pneumonia Severity Index (A)</p> Signup and view all the answers

<p>Twice daily (A)</p> Signup and view all the answers

<p>Atypical pneumonia is a gradual onset characterized by low grade fever, headache, fatigue, myalgias, dry, nonproductive cough (B)</p> Signup and view all the answers

<p>patchy alveolar densities or segmental lobar infiltrates (A)</p> Signup and view all the answers

<p>lobar consolidation (B)</p> Signup and view all the answers

<p>PCR or sputum swab (A)</p> Signup and view all the answers

<p>Macrolide (Azithromycin or Clarithromycin 500 mg BID 10 days)</p> Signup and view all the answers

<p>Amoxicillin 1 gm TID 5-7 days A macrolide (Azithromycin)</p> Signup and view all the answers

<p>A macrolide + beta lactam or doxycycline (Augmentin 875/125 BID + Azithromycin 500 mg on day 1 and 250 mg daily)</p> Signup and view all the answers

<p>Cough medicines (A)</p> Signup and view all the answers

Signup and view all the answers

<p>Codeine (C)</p> Signup and view all the answers

A self-limited viral inflammation of the bronchi, characterized by a cough lasting 1 to 3 weeks.

Persistent cough, low-grade fever, headache, wheezing, sore throat, and malaise without high fever.

Cough must last at least 5 days for it to be classified as acute bronchitis but resolves within 3 weeks.

Viruses cause 90% of acute bronchitis cases, including Influenza A & B, adenovirus, and rhinovirus.

Bacterial infections (5-10% cases) mainly include Streptococcus pneumoniae and Hemophilus influenzae.

Acute bronchitis is most common in patients over 50 years old and smokers.

Low-grade fever or no fever indicates acute bronchitis; high fever suggests pneumonia.

Normal vital signs (absence of crackles, tachycardia) alongside non-high fever support acute bronchitis diagnosis.

Diagnosis is made if cough lasts > 7 days without consolidation.

No lung consolidation; clear breath sounds upon auscultation.

Elevated temperature indicates bacterial infection; afebrile to low-grade suggests viral.

Chest X-ray is useful if symptoms suggest pneumonia, especially with fever, tachycardia, or tachypnea.

Chronic if cough lasts > 3 weeks; consider other conditions like asthma or COPD.

Elevated CRP (>10 mcg/dl) indicates a higher likelihood of pneumonia.

Includes humidifiers, fluids, and antipyretics; resolves within weeks.

Antibiotics are prescribed only for confirmed bacterial infections, such as pertussis.

A blockage in a pulmonary artery, often due to blood clots from DVT, causing pleuritic chest pain, dyspnea, and tachycardia.

Signs include shortness of breath that worsens with exertion, pitting edema, and a dry cough; physical exam may show S3 and elevated JVD.

Common early signs include fever, dry cough, shortness of breath, fatigue, chills, and gastrointestinal issues.

Severe lung inflammation caused by COVID-19 that can lead to ARDS and difficulty breathing due to alveolar damage.

Tests to determine current or past infection, including viral tests (NAATs, antigen) and antibody tests for past infections only.

Abrupt onset with fever, chills, cough, pleuritic pain, and consolidation.

Shows ground glass opacities, bronchial wall thickening, and confluent areas of consolidation.

Caused by nonbacterial organisms like Mycoplasma, Chlamydia, and Legionella.

Gradual onset with low-grade fever, headache, fatigue, and dry cough.

Reveals fine crackles/rales, no signs of consolidation, and clear mucus.

PCR or sputum swab are gold standards for diagnosing atypical pneumonia.

Lobar consolidation, cavitation, and large pleural effusions in bacterial pneumonia on CXR.

Common treatments include Azithromycin, Clarithromycin, and Doxycycline for atypical pneumonia.

Vaccine for individuals 12 years and older, requiring 2 shots 3 weeks apart.

Vaccine for individuals 18 years and older, requiring 2 shots 4 weeks apart.

Single-shot vaccine for individuals 18 years and older, fully effective after 2 weeks.

Inflammation conditions reported after COVID-19 vaccination, mostly in young adults.

Treatment for healthy patients using beta lactam + macrolide or doxycycline.

Use macrolide or fluoroquinolone antibiotics for outpatient treatment.

Severity assessment tool to determine hospitalization needs for pneumonia patients.

Tool to evaluate the need for hospitalization in pneumonia cases.

Avoid using Azithromycin in cases of QT prolongation, torsades de pointes, bradyarrhythmias, and uncompensated heart failure.

No antibiotics are recommended for immunocompetent adults with productive cough attributed to acute bronchitis.

Hospitalization is needed for progressive dyspnea, oxygen saturation < 90%, or signs of sepsis.

Pneumonia is a leading cause of morbidity and mortality, especially in older adults and young children under 5.

Typical pneumonia is primarily caused by Streptococcus pneumoniae, while atypical pneumonia involves organisms undetected by Gram stain.

In Community Acquired Pneumonia (CAP), the diagnosis is made using history and physical exam, not usually requiring identification of the causative agent.

Symptoms include fever, chills, cough, dyspnea, and crackles; chest X-ray may be normal initially.

Streptococcus pneumoniae is the leading cause of bacterial pneumonia across all age groups, characterized by high fever and productive cough.

Inflammation of trachea and major bronchi; self-limited.

Cough lasting 1-3 weeks, often with low-grade fever and malaise.

90% viral; includes Influenza, adenovirus, and RSV.

Cough must last at least 5 days, resolves within 3 weeks.

Low-grade fever in bronchitis; high fever signals pneumonia.

Normal vital signs with cough, may present rhonchi or wheezing.

Higher incidence in smokers and individuals over 50 years old.

Cough lasting more than 2 months indicates chronic bronchitis.

Symptoms include fever, cough, dyspnea, and pleuritic chest pain.

Typical pneumonia primarily caused by Streptococcus pneumoniae, leading to high fever and cough.

Atypical pneumonia caused by organisms like Mycoplasma pneumoniae, undetectable by Gram stain.

Hospitalization needed for progressive dyspnea, oxygen saturation < 90%, or sepsis signs.

Pneumonia is the 2nd leading cause of death in children under 5 years old.

Auscultation reveals crackles, dullness to percussion, and egophony signs of consolidation.

Older adults and those with chronic diseases are at higher risk for pneumonia.

Chest X-ray can show lobar consolidation, cavitation, or may be normal early in disease.

Diagnosis is confirmed if cough lasts > 7 days without lung consolidation.

Chest X-ray is needed if pneumonia is suspected, especially with high fever or tachycardia.

Consider chronic bronchitis if cough lasts > 3 weeks with sputum production.

CRP levels >10 mcg/dl indicate a higher likelihood of pneumonia.

Includes humidifiers, fluids, and antipyretics; typically resolves within weeks.

Antibiotics are prescribed only for confirmed bacterial infections, like pertussis.

Elevated temperature typically indicates a bacterial cause rather than viral.

B2 adrenergic agonists like albuterol are used for wheezing if there’s a past asthma history.

Signs include dyspnea, hemoptysis, pleuritic chest pain, tachycardia, and tachypnea.

Symptoms include SOB worsening with exertion, pitting edema, and dry cough. Exam may show S3 and elevated JVD.

Common signs include fever, anorexia, fatigue, night sweats, productive cough with blood-stained sputum, and weight loss.

Common signs include fever, dry cough, shortness of breath, fatigue, chills, and gastrointestinal symptoms.

Severe lung inflammation possibly leading to ARDS and difficulty breathing due to alveolar damage.

Gradual onset with low-grade fever, headache, fatigue, and dry cough.

Infection rates highest among younger school-age children, military recruits, and college students.

Reveals fine crackles/rales with no consolidation and clear mucus.

Bilateral patchy alveolar densities or segmental lobar infiltrates, atelectasis, and small pleural effusions.

PCR or sputum swab are the gold standards for diagnosis.

Chest X-ray reliably shows infiltrates but may be normal in pneumonia cases.

Typical pneumonia caused by bacteria like Streptococcus; atypical involves nonbacterial organisms.

Azithromycin, Clarithromycin, Doxycycline, or Levofloxacin are common treatment options.

Main symptom is persistent cough, often dry initially, may produce light colored sputum and cause burning pain.

Includes rhinorrhea, sore throat, malaise, low-grade fever; present in many cases of acute bronchitis.

Cough may start dry and nonproductive but becomes productive as the illness progresses; pain may accompany inspiration.

High-grade fever is uncommon in acute bronchitis; its presence suggests pneumonia.

Cough must last for at least 5 days and resolves within 3 weeks to be classified as acute bronchitis.

Cough lasting more than 2 months indicates chronic bronchitis; acute resolves in weeks.

Higher incidence in smokers and individuals over age 50; these groups are at greater risk.

Acute bronchitis is typically self-limited, resolving within weeks without treatment.

Fever, anorexia, night sweats, blood-stained sputum, and weight loss are typical.

Includes viral tests for active infection (NAATs, antigen) and antibody tests for past infections.

Azithromycin is contraindicated in QT prolongation, torsades de pointes, bradyarrhythmias, and uncompensated heart failure.

Pneumonia is a leading cause of morbidity and mortality, especially in older adults and children under 5.

Clinical manifestations of community-acquired pneumonia (CAP) include fever, chills, cough, dyspnea, and crackles.

Hospitalization is needed for progressive dyspnea, oxygen saturation below 90%, or signs of sepsis.

Bacterial pneumonia often presents with abrupt onset high fever, shaking chills, productive cough, and pleuritic chest pain.

Reevaluation is necessary if symptoms do not respond to treatment and persist for more than 3 weeks.

Gradual onset with low-grade fever, dry cough, and myalgias.

Caused by Mycoplasma, Chlamydia, and Legionella.

Highest infection rates in younger groups: children, military recruits, and college students.

PCR or sputum swab are the best diagnostic tests.

CXR confirms new infiltrates; may be normal even in pneumonia cases.

Commonly treated with Azithromycin, Clarithromycin, or Doxycycline.

Inflammation conditions reported post COVID-19 vaccination, particularly in younger adults.

Typically shows clear breath sounds, no lung consolidation.

Chest X-ray is useful if pneumonia is suspected with high fever or tachycardia.

Consider asthma, pneumonia, or COPD if cough lasts longer than 3 weeks.

Elevated levels (>10 mcg/dl) indicate a higher likelihood of pneumonia.

High fever suggests bacterial infection, while low-grade typically indicates viral.