INSTRUCTIONS Evidence-based diagnosis and management of acute bronchitis
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Evidence-based diagnosis and management of acute bronchitis
GENERAL PURPOSE: The purpose of this learning activity is to provide information about the current evidence-based recommendations for the diagnosis and management of acute bronchitis in adults. Learning Objectives: After reading this article and taking this test, you will be able to: 1. Identify the current evidence-based recommendations for the diagnosis of acute bronchitis in adults. 2. Select current evidence-based recommendations for the management of acute bronchitis in adults.
- Acute bronchitis is characterized by the primary symptom of
- a productive cough lasting 2 weeks.
- a productive cough and fever lasting 3 weeks.
- a cough lasting less than 3 weeks.
- intermittent coughing accompanied by dyspnea lasting 10-15 days.
- Acute bronchitis occurs most commonly
- in people over age 70.
- during the fall and winter months.
- during the late summer and fall.
- during the winter and spring.
- National surveys indicate that the most frequent clinical symptom for which individuals seek care from outpatient providers is
- Acute bronchitis stems from
- a thinning of the bronchial mucosa.
- desquamation of the tracheal mucosa.
- thickening of the airway's basement membrane.
- inflammation of the bronchial epithelium.
- The mean duration of cough in cough illness in adults is
- 10.8 days.
- 14 days.
- 17.8 days.
- 22.4 days.
- The presence of purulent sputum in acute bronchitis
- indicates the need to obtain a chest X-ray.
- is not indicative of a bacterial infection.
- is symptomatic of Mycoplasma pneumoniae.
- is uncommon in acute bronchitis.
- Which symptom is typically absent in acute bronchitis?
- runny nose
- sore throat
- nasal congestion
- On physical examination, which sign might be expected in acute bronchitis?
- increased fremitus
- dullness to percussion
- As a serum biomarker in acute bronchitis, the level of procalcitonin
- increases in response to viral infections.
- shows promise for distinguishing bacterial from viral etiologies.
- increases in the presence of lung tissue inflammation.
- decreases in the presence of bacterial infections.
- Which may be the least reliable parameter for ruling out pneumonia in patients over age 75?
- respirations over 24/minute
- decreased oxygen saturation
- absence of fever
- decreased mental status
- Which statement about the reliability of chest X-ray for diagnosing pneumonia is accurate?
- Dehydrated patients may have a false-negative result.
- They are reliable in 97% of cases.
- 15% of patients have a false-negative result.
- They can reliably supersede clinical judgment.
- An important consideration in the diagnosis of influenza is that
- its symptoms are nonspecific.
- its peak season occurs before December.
- accompanying body aches last 1-2 weeks while the cough often lasts 7-10 days.
- rapid diagnostic tests should be used as the first step in diagnosis.
- Which statement about pertussis is correct?
- Diagnosis of this viral infection is based on the characteristic “whoop” cough.
- Among its severe complications are dehydration and rib fractures.
- Its incidence has decreased in older adults.
- It should be considered when cough lasts more than 1 week without apparent cause.
- The evidence-based recommended management of acute bronchitis is
- amoxicillin for 14 days.
- antitussive prescription medication for 10 days.
- primarily supportive.
- expectorants and codeine.
- The 2012 Cochrane review of over-the-counter medications for acute cough
- reported mixed results.
- reported the antihistamine/decongestant combinations were the most effective.
- recommended antitussives for 10 days.
- reported terfenadine as the most effective expectorant.
- Which of the following statements about cough suppression is correct?
- Codeine is the research-supported gold standard for cough suppression.
- Hydrocodone is effective in suppressing coughs.
- Tramadol is more effective than placebo in suppressing cough in acute bronchitis.
- Little evidence supports using codeine and hydrocodone for treating acute cough.
- Which treatment is being researched for suppressing the cough reflex?
- P. sidoides
- guaifenesin with benzonatate
- nebulized lidocaine