UH Resp Diseases II

• What is bronchitis?

  Bronchitis is an inflammation of the bronchi in the lungs.
• What causes the narrowing of airways in bronchitis?

  Narrowing of the airways is caused by tissue swelling and excess mucus production.
• What are the features of acute bronchitis?

  • Cough (often productive of sputum)
  • Fever
  • Cough usually lasts about 2 weeks
• What is the typical color of sputum produced in acute bronchitis?

  The sputum is typically clear, yellow, or green colored.
• What does dark brown or grey colored sputum suggest?

  It may be more suggestive of true pneumonia.
• What is a common symptom of acute bronchitis?

  Fever is a common symptom of acute bronchitis.
• How long does a cough usually last in acute bronchitis?

  A cough usually lasts about 2 weeks.
• What is the nature of treatment for acute bronchitis?

  No treatments have been proven to speed up recovery as the condition is self-limiting.
• When should an immediate antibiotic prescription be considered for acute bronchitis?

  It should be considered for a person at higher risk of complications.

  
• What is the first-line antibiotic choice for adults with acute bronchitis?

  The first-line choice is oral doxycycline.
• What is the dosage regimen for doxycycline in adults?

  200 mg on the first day, then 100 mg once a day for 4 days.
• Who should not be given doxycycline?

  Doxycycline should not be given to pregnant women.
• What is the first-line antibiotic choice for young people aged 12-17 with acute bronchitis?

  The first-line choice is oral amoxicillin.
• What is the dosage regimen for amoxicillin in young people?

  500 mg three times a day for 5 days.
• What is asthma?

  • A common chest condition
  • Temporary narrowing of the breathing tubes
  • Caused by hyper-reactivity and oversensitivity

  
• What happens to the airways in asthma?

  The airways experience inflammation, swelling, increased mucus, and muscle tightening.

  
• How many people in the UK have asthma?

  5.4 million people have asthma in the UK.
• In which age group is the incidence of asthma higher?

  The incidence of asthma is higher in children than in adults.
• What are the risk factors involved in the development of asthma?

  • Personal or family history of atopic disease
  • Male sex for pre-pubertal asthma, female sex for persistence
  • Respiratory infections in infancy
  • Exposure to tobacco smoke
  • Premature birth and low birth weight
  • Obesity
  • Social deprivation
  • Exposure to inhaled particulates
  • Workplace exposures
• How does airway inflammation occur in asthma?

  1. Immune response to harmless triggers
  2. Release of inflammatory mediators
  3. Airway swelling
  4. Mucus overproduction
  5. Airway hyperresponsiveness

  
• What is bronchospasm in asthma?

  Bronchospasm is a sudden constriction of the muscles in the walls of the bronchioles.
• What does noisy asthma indicate?

  Noisy asthma occurs when airways are inflamed and very sensitive.
• What are common symptoms of asthma?

  Common symptoms include coughing, wheezing, chest tightness, and shortness of breath.
• When is an asthma cough typically worse?

  An asthma cough is often worse at night or early morning.
• What is wheezing in asthma?

  Wheezing is a whistling or squeaky sound especially when breathing out.
• What does chest tightness feel like in asthma?

  Chest tightness can feel like something is squeezing or sitting on your chest.
• What does shortness of breath feel like in asthma?

  Shortness of breath may feel like you can’t catch your breath or breathe deeply enough.
• What tests are used to diagnose asthma?

  • Spirometry
  • Bronchodilator reversibility (BDR)
  • Fractional exhaled nitric oxide (FeNO) testing
  • Peak expiratory flow (PEF) readings
  • Direct bronchial challenge testing
• What does spirometry measure?

  Spirometry measures how much air you can breathe out in one forced breath.
• What is the normal FEV1/FVC ratio?

  The normal FEV1/FVC ratio is greater than 70%.
• What FeNO level is considered a positive result for asthma diagnosis in adults?

  A FeNO level of 40 parts per billion (ppb) or higher is considered positive.
• What FeNO level is considered a positive result for asthma diagnosis in children aged 5 to 16 years?

  A FeNO level of 35 ppb is considered positive in this group.
• What does PEF variability indicate in asthma diagnosis?

  PEF variability can support an asthma diagnosis if there is diagnostic uncertainty.
• What percentage of PEF variability is regarded as a positive result?

  A value of more than 20% variability is regarded as a positive result.
• What does a PC20 value of 8 mg/ml or less indicate?

  A PC20 value of 8 mg/ml or less is regarded as a positive result in a bronchial challenge test.
• What is the diagnostic summary for children under five years with suspected asthma?

  • Use clinical judgment based on positive objective test results
  • Consider noted signs and symptoms
  • Attempt to perform at least 2 other objective tests if possible

  
• What is the mainstay of medical management in asthma?

  Inhalers are the mainstay of medical management in asthma.
• What do short-acting beta agonists do in asthma treatment?

  They quickly relax the smooth muscles around the airways during an asthma attack.
• What is the focus of the section titled "Acute Asthma in Children"?

  It discusses monitoring and managing asthma in patients and healthcare providers.

  
• What questions should be asked to check for possible occupational asthma?

  • Are symptoms better on days away from work?
  • Are symptoms better during holidays?
  • Ensure all answers are recorded for later review.