LRTI: Bronchitis

Question 1

What is Bronchitis? (3 things)

Answer 1

1. Chest infection
2. Inflamm of large airways of LRTI (Trachea + Major bronchi)
3. Usually self limiting

Question 2

What are the Risk Factors for Bronchitis? (4 things)

Answer 2

1. Smoking
2. Chronic lung disease (COPD / asthma / CF)
3. Chronic exposure to air pollution
4. FHx

Question 3

What are the causes of Bronchitis? (2 things)

Answer 3

1. Viral infection (most common) (95%)
   * Influenza / Rhinovirus / Corona
2. Bacterial infection (5%)

Question 4

What is the pathophysiology of Bronchitis? (3 things)

Answer 4

Irritation + inflammation cause:

1. Impaired ciliary function
2. Mucous membrane swelling
3. Increased mucus production → prod cough (characteristic cough of bronchitis)

Question 5

What are the CF of Bronchitis? (4 things)

Answer 5

1. Rhinorrhoea (runny nose)
2. Prod cough (clear / yellow / purulent* sputum)
3. Sore chest / throat
4. Wheeze (bc mucus / narrow airway)

*purulent = pus

Question 6

What CF are more consistent with PNEUMONIA than Bronchitits? (4 things)

Answer 6

1. Fever
2. Tachypnea
3. Dullness to percussion (consolidation)
4. Tactile fremitus (louder 99) (consolidation)

Question 7

How is a diagnosis of Bronchitis made?

Answer 7

Clinically

(History + Exam, acute onset cough, followed by a URTI with no evidence of pneumonia)

Question 8

What investigations can you do for Brochitis if you sus Pneumonia instead?

When is this indicated? (4 things)

Answer 8

CXR

Indicated if you have Pneumonia signs:

1. Fever
2. Tachypnea
3. Dullness to percussion (consolidation)
4. Tactile fremitus (louder 99) (consolidation)

Question 9

What will you see in a CXR that you requested in sus Bronchitis but you acc sus Pneumonia?

Answer 9

If bronchitis = normal CXR

If pneumonia = consolidation

Question 10

What are the management options for Bronchitis? (4 things)

Answer 10

1. Usually self-limiting
2. Analgesia
3. Fluids
4. Abx if Bacterial Bronchitis (5% like we said) (1st line = Doxycycline)

Question 11

What is the FIRST LINE Abx for Bacterial Bronchitis?

Answer 11

Doxycycline

Question 12

Who is Doxycycline contra-indicated in?

What should you give them instead?

Answer 12

Pregnant + Kids

Amoxicillin