Internal
Medicine
,
, 28. Acute Bronchitis
Definition: Acute inflammation of the bronchi
Etiology
➢ Virus or bacterial infection
➢ Air pollution
Symptoms
➢ Cough (obligatory symptom) dry in the beginning, later with sputum
➢ Fever, weakness, fatigue, loss of appetite;
➢ Retrosternal pain during cough as a sign of tracheitis.
➢ Shortness of breath in bronchiolitis
Physical Examination
➢ Intoxicated face if the patient is with fever
➢ Coarse or decreased vesicular breathing with snoring wheezes and bronchi.
➢ Whistling wheezes in spastic bronchitis
Lab Tests
➢ Increased WBC and sedimentation rate
Microbiology
➢ Sputum culture for bacterial infection
➢ Serological test for viral infections
Radiology
➢ Increased lung markings
Spirometry
➢ Restrictive type respiratory failure in bronchiolitis. (Decreased FVC and FEV1,
FEV1/FVC equal or over 70%)
➢ Blood gases hypoxemia often with hypercapnia in bronchiolitis
Complications
➢ Pneumonia
➢ Chronic bronchitis
Main diagnostic tasks besides establishing of the primary diagnosis
➢ To exclude pneumonia with X-ray
➢ To establish the etiology – sputum culture or serological test
➢ To evaluate the respiratory function in the most severe cases – blood gases
➢ In prolonged cases – skin test for allergy
, 29. COPD
➢ Chronic obstructive pulmonary disease (COPD) describes a group of lung
conditions that make it difficult to empty air out of the lungs because the
airways are narrow
➢ Two of these lung conditions are persistent bronchitis and emphysema
Chronic Bronchitis
Definition: Cough that has lasted for three months in a row during two consecutive
years
Predisposition Factors
➢ Frequent respiratory infections, especially bronchitis and sinusitis
➢ Smoking
➢ Polluted environment
Symptoms
➢ Occasionally slight morning cough during exacerbation
➢ Physical examination, lab tests, microbiology, radiology, spirometry, blood gases in
cases with exacerbation same as in acute bronchitis
Complications
➢ Bronchiectasis
➢ Pulmonary emphysema (chronic obstructive pulmonary disease)
➢ Pneumofibrosis
➢ Possible predisposition factor for neoplasm
Main Diagnostic Tasks
➢ Evaluation of the respiratory function – blood gases
➢ Spirometry
➢ In cases with bronchospasm – skin test for allergens
➢ In cases of exacerbation – the same as in acute bronchitis – etiology and excluding
pneumonia
➢ anamnesis, physical examination, X-ray, evaluation of the respiratory function
Medicine
,
, 28. Acute Bronchitis
Definition: Acute inflammation of the bronchi
Etiology
➢ Virus or bacterial infection
➢ Air pollution
Symptoms
➢ Cough (obligatory symptom) dry in the beginning, later with sputum
➢ Fever, weakness, fatigue, loss of appetite;
➢ Retrosternal pain during cough as a sign of tracheitis.
➢ Shortness of breath in bronchiolitis
Physical Examination
➢ Intoxicated face if the patient is with fever
➢ Coarse or decreased vesicular breathing with snoring wheezes and bronchi.
➢ Whistling wheezes in spastic bronchitis
Lab Tests
➢ Increased WBC and sedimentation rate
Microbiology
➢ Sputum culture for bacterial infection
➢ Serological test for viral infections
Radiology
➢ Increased lung markings
Spirometry
➢ Restrictive type respiratory failure in bronchiolitis. (Decreased FVC and FEV1,
FEV1/FVC equal or over 70%)
➢ Blood gases hypoxemia often with hypercapnia in bronchiolitis
Complications
➢ Pneumonia
➢ Chronic bronchitis
Main diagnostic tasks besides establishing of the primary diagnosis
➢ To exclude pneumonia with X-ray
➢ To establish the etiology – sputum culture or serological test
➢ To evaluate the respiratory function in the most severe cases – blood gases
➢ In prolonged cases – skin test for allergy
, 29. COPD
➢ Chronic obstructive pulmonary disease (COPD) describes a group of lung
conditions that make it difficult to empty air out of the lungs because the
airways are narrow
➢ Two of these lung conditions are persistent bronchitis and emphysema
Chronic Bronchitis
Definition: Cough that has lasted for three months in a row during two consecutive
years
Predisposition Factors
➢ Frequent respiratory infections, especially bronchitis and sinusitis
➢ Smoking
➢ Polluted environment
Symptoms
➢ Occasionally slight morning cough during exacerbation
➢ Physical examination, lab tests, microbiology, radiology, spirometry, blood gases in
cases with exacerbation same as in acute bronchitis
Complications
➢ Bronchiectasis
➢ Pulmonary emphysema (chronic obstructive pulmonary disease)
➢ Pneumofibrosis
➢ Possible predisposition factor for neoplasm
Main Diagnostic Tasks
➢ Evaluation of the respiratory function – blood gases
➢ Spirometry
➢ In cases with bronchospasm – skin test for allergens
➢ In cases of exacerbation – the same as in acute bronchitis – etiology and excluding
pneumonia
➢ anamnesis, physical examination, X-ray, evaluation of the respiratory function
