Know presentation, DX and Management Diagnoses List VISE 25

Acute bronchitis- DESCRIPTION Acute cough due to inflammation of the bronchioles, bronchi, and trachea; usually follows an upper respiratory infection or exposure to a chemical irritant. ETIOLOGY  Adenovirus  Rhinovirus  Influenza A and B  Parainfluenza RISK FACTORS  Upper respiratory infection  Air pollutants  Smoking and/or secondary exposure  Reflux esophagitis  Allergy  Chronic obstructive pulmonary disease  Acute and chronic sinusitis  Infants  Older adults  Immunosuppression ASSESSMENT FINDINGS  Cough: dry and nonproductive, then productive; may be purulent  URI symptoms  Fatigue  Fever due to bacterial infection; more common in smokers and patients with COPD  Fever due to viral cause (unusual after first few days)  Burning sensation in chest  Crackles, wheezes  Chest wall pain DIFFERENTIAL DIAGNOSIS  Pneumonia  Tuberculosis  Asthma DIAGNOSTIC STUDIES  Decision criteria for chest radiographs: tachypnea, hypoxia, fever, abnormal lung exam  Only consider chest X-ray if high index of suspicion for pneumonia or superimposed heart failure  Consider PPD: expect negative results  PREVENTION Smoking cessation Avoid known respiratory irritants Treat underlying conditions that contribute to risk (asthma, gastroesophageal reflux disease, etc.) Influenza immunization for high-risk populations