Bronchitis and Bronchiolitis Quiz

Study Notes

Bronchitis is an inflammatory condition of the large elements of the tracheobronchial tree.
Bronchitis usually affects older children and adults.
Chronic bronchitis is a component of chronic obstructive pulmonary disease (COPD).

Infection of the trachea and bronchi leads to hyperemic and edematous membranes, increased bronchial secretions, and damage to the respiratory epithelium.
Damage to the respiratory epithelium can be mild or severe.
Increased bronchial secretions may impair mucociliary actions.
Thickening of the bronchial wall is present, and there is an increased number of mucus-secreting goblet cells in smaller bronchi.

Viruses are the most common cause of acute bronchitis.
Rhinovirus, coronavirus, influenza virus, and adenovirus are common viral pathogens.
Less frequent bacterial causes include Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Bordetella pertussis.
Acute exacerbations of chronic bronchitis are often caused by H. influenzae, M. catarrhalis, S. pneumonia, and gram-negative pathogens such as E. coli, Enterobacter species, and Klebsiella species.

Cough is a common symptom, initially nonproductive, then productive with mucopurulent sputum.
Fever is rare.
Symptoms are more pronounced in patients with underlying lung disease.
Microbiologic tests are generally of limited use.

Mild to moderate cough with increased sputum production for at least 3 consecutive months for 2 years.
Simple chronic bronchitis is characterized by no major risk factors and sputum flora reflects the common associated pathogens.
Complicated chronic bronchitis refers to patients with two or more disease-associated risk factors, such as FEV1, home oxygen use, underlying cardiac disease, use of immunosuppressant, and use of antibiotics for an exacerbation within the past 3 months.