28)Acute thracheobronchitis and bronchitis
Definition: inflammation of the bronchi.
Ethyiology; virus or bacterial infection, air pollution
Symptoms:Cough (obligatory) 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 ronchi.
Whistling wheezes in spastic bronchitis.
Lab test:
Occasionally increased WBC(3.5-5.5) and sedimentation rate(in men 5-15;
in women 8-20)
Microbiology
Sputum culture for bacterial infection
Serological test for viral infections
Radiology
Increased lung markings
Spirometry
Restrictive type respiratory failure in bronchiolitis
Blood gases hypoxemia often with hypercapnia
Complications
Pneumonia
Chronic bronchitis
acute thrachea bronchitis
definition :is an common inflammation afflicting the lower respiratory
tract,composed of tracheitis and bronchitis.
etiology:virus ,bacteria infection,chemical and physical irratants
symptoms:
dry cough(obligatory)later with sputum (sometime with blood)
fever
weakness
fatigue
shortness of breath
ronchi
phsycal examinaton:
-intoxicated face if the patient is with fever
-coarse or decreased vesicular breathing with snoring wheezes and ronchi
lab test:
occasionally increased WBC(3.5-10.5)
sedimentation rate (in men 5-15—in women 8-20)
microbiology:
-sputum culture for bacterial infection
-serological test for viral infection
radiology:
incread lung margines
spirometry:
restrictive type respiratory failure in bronchiolitis(decreased)
blood gases hypoxemia often with hypercapnia
,Complications:
pneumonia ,chronic bronchitis.
29)Chronic Obstructive Pulmonary Diesease
Definition: cough three months in a row, during two consecutive years
Predisposition factors
Frequent respiratory infections, especially bronchitis and sinusitis, smoking,
polluted
environment, cold
Symptoms
Occasionally slight morning cough, during exacerbation same as acute
bronchitis
phsycal examinaton:
-intoxicated face if the patient is with fever
-coarse or decreased vesicular breathing with snoring wheezes and ronchi
lab test:
occasionally increased WBC(3.5-10.5)
sedimentation rate (in men 5-15—in women 8-20)
microbiology:
-sputum culture for bacterial infection
-serological test for viral infection
radiology:
incread lung margines
spirometry:
restrictive type respiratory failure in bronchiolitis(decreased)
blood gases hypoxemia often with hypercapnia
Complications
Bronchiaectases
Pulmonary emphysema
Pneumofibrosis
Pulmonary emphysema
Definition – anatomical condition of the lungs with constant enlargement
of the airspaces
distally from the terminal bronchioli and destruction of the alveoli
membranes.
Ethyology, pathogenesis and predisposition factors
Main pathogenic factor is bronchial obstruction in few cases congenital
factor –
deficiency of alpha-1-antitrypsin.
Pulmonary emphysema is a complication of chronic bronchitis,
bronchiectasis, and bronchial asthma
Symptoms: shortness of breath, initially during exercise, later at rest, but it
is not relieved significantly in sitting position.
Easy tiredness, fatigue, often cough with sputum.
Physical examination
In patient with respiratory failure general cyanosis and polycythaemia
Short neck, sometimes high neck veins
Emphysema type chest
Decreased vocal fremitus, box-like percussion sound, lower position of
lung bases,
,reduced respiratory mobility, decreased vesicular breathing with
prolonged exhale, often
whistling and snoring wheezes.
Lab tests
Increased HB(120-180), RBC(3,5-5,5), HTC(35-55) and low sedimentation
rate(in men 5-15—inwomen 8-20) in patients with respiratory failure and
polycytaemia.
Radiography
More air in the lung, dilated intercostal spaces, often increased lung
markings for
concomitant chronic bronchitis and bronchiectasis.
Spirometry - restrictive type respiratory failure.
Blood gazes – hypoxemia and hypercapnia, decreased oxygen
saturation.
Complications
Right heart failure very rare pneumothorax.
Pulmonary emphysema, chronic bronchitis and bronchiectasis
Bronchiectases
Definition: local dilatation of the bronchi
Predisposition factors
Chronic bronchitis, pneumonia, congenital (cystic fibrosis)
Symptoms
Cough with much sputum, especially in the morning and breath odor.
The sputum is
in three levels – upper foam-like, middle – mucous, lower – purulent,
occasionally
haemoptysis (blood in the sputum)
During exacerbation the same as in acute bronchitis, but more severe,
nearer to
pneumonia
Physical examination
Mainly in auscultation - decreased vesicular breathing with ronchi, which
are resonant,
when there is inflammation of the parenchyma
Occasionally clubbing of the fingers
Lab tests
Increased WBC(3,5-5,5) and sedimentation rate(in men 5-15-in women
8-20)
Microbiology
Sputum culture
Radiology
Increased lung markings, stretching to the periphery of the lung
CAT - cylindrical or sack-like dilatations of the bronchi.
Spirometry
Occasionally restrictive type respiratory failure
Blood gases hypoxemia, sometimes with hypercapnia
Complications
Acute- Local: pneumonia, pulmonary abscesses
General: myocarditis, pericarditis, endocarditis, encephalitis, meningitis,
sepsis;
, Chronic- Local: pneumofibrosis, pulmonary emphysema
General: amyloidosis
30) Bronchiectases
Definition: local dilatation of the bronchi
Predisposition factors
Chronic bronchitis, pneumonia, congenital (cystic fibrosis)
Symptoms
Cough with much sputum, especially in the morning and breath odor.
The sputum is
in three levels – upper foam-like, middle – mucous, lower – purulent,
occasionally
haemoptysis (blood in the sputum)
During exacerbation the same as in acute bronchitis, but more severe,
nearer to
pneumonia
Physical examination
Mainly in auscultation - decreased vesicular breathing with ronchi, which
are resonant,
when there is inflammation of the parenchyma
Occasionally clubbing of the fingers
Lab tests
Increased WBC(3,5-5,5) and sedimentation rate(in men 5-15-in women 8-
20)
Microbiology
Sputum culture
Radiology
Increased lung markings, stretching to the periphery of the lung
CAT - cylindrical or sack-like dilatations of the bronchi.
Spirometry
Occasionally restrictive type respiratory failure
Blood gases hypoxemia, sometimes with hypercapnia
Complications
Acute-
Local: pneumonia, pulmonary abscesses
General: myocarditis, pericarditis, endocarditis, encephalitis, meningitis,
sepsis;
Chronic-
Local: pneumofibrosis, pulmonary emphysema
General: amyloidosis
31)Bronchial Asthma
Definition: in most cases allergic disease causing attacks of
breathlessness while exhaling
Classification: atopic and nonatopic
Ethyology and predisposition factors:
For the atopic asthma: family predisposition with increased levels of IgE
For the non-atopic type: infections - mainly pneumonia or sinusitis in
childhood
Special types of asthma:
Definition: inflammation of the bronchi.
Ethyiology; virus or bacterial infection, air pollution
Symptoms:Cough (obligatory) 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 ronchi.
Whistling wheezes in spastic bronchitis.
Lab test:
Occasionally increased WBC(3.5-5.5) and sedimentation rate(in men 5-15;
in women 8-20)
Microbiology
Sputum culture for bacterial infection
Serological test for viral infections
Radiology
Increased lung markings
Spirometry
Restrictive type respiratory failure in bronchiolitis
Blood gases hypoxemia often with hypercapnia
Complications
Pneumonia
Chronic bronchitis
acute thrachea bronchitis
definition :is an common inflammation afflicting the lower respiratory
tract,composed of tracheitis and bronchitis.
etiology:virus ,bacteria infection,chemical and physical irratants
symptoms:
dry cough(obligatory)later with sputum (sometime with blood)
fever
weakness
fatigue
shortness of breath
ronchi
phsycal examinaton:
-intoxicated face if the patient is with fever
-coarse or decreased vesicular breathing with snoring wheezes and ronchi
lab test:
occasionally increased WBC(3.5-10.5)
sedimentation rate (in men 5-15—in women 8-20)
microbiology:
-sputum culture for bacterial infection
-serological test for viral infection
radiology:
incread lung margines
spirometry:
restrictive type respiratory failure in bronchiolitis(decreased)
blood gases hypoxemia often with hypercapnia
,Complications:
pneumonia ,chronic bronchitis.
29)Chronic Obstructive Pulmonary Diesease
Definition: cough three months in a row, during two consecutive years
Predisposition factors
Frequent respiratory infections, especially bronchitis and sinusitis, smoking,
polluted
environment, cold
Symptoms
Occasionally slight morning cough, during exacerbation same as acute
bronchitis
phsycal examinaton:
-intoxicated face if the patient is with fever
-coarse or decreased vesicular breathing with snoring wheezes and ronchi
lab test:
occasionally increased WBC(3.5-10.5)
sedimentation rate (in men 5-15—in women 8-20)
microbiology:
-sputum culture for bacterial infection
-serological test for viral infection
radiology:
incread lung margines
spirometry:
restrictive type respiratory failure in bronchiolitis(decreased)
blood gases hypoxemia often with hypercapnia
Complications
Bronchiaectases
Pulmonary emphysema
Pneumofibrosis
Pulmonary emphysema
Definition – anatomical condition of the lungs with constant enlargement
of the airspaces
distally from the terminal bronchioli and destruction of the alveoli
membranes.
Ethyology, pathogenesis and predisposition factors
Main pathogenic factor is bronchial obstruction in few cases congenital
factor –
deficiency of alpha-1-antitrypsin.
Pulmonary emphysema is a complication of chronic bronchitis,
bronchiectasis, and bronchial asthma
Symptoms: shortness of breath, initially during exercise, later at rest, but it
is not relieved significantly in sitting position.
Easy tiredness, fatigue, often cough with sputum.
Physical examination
In patient with respiratory failure general cyanosis and polycythaemia
Short neck, sometimes high neck veins
Emphysema type chest
Decreased vocal fremitus, box-like percussion sound, lower position of
lung bases,
,reduced respiratory mobility, decreased vesicular breathing with
prolonged exhale, often
whistling and snoring wheezes.
Lab tests
Increased HB(120-180), RBC(3,5-5,5), HTC(35-55) and low sedimentation
rate(in men 5-15—inwomen 8-20) in patients with respiratory failure and
polycytaemia.
Radiography
More air in the lung, dilated intercostal spaces, often increased lung
markings for
concomitant chronic bronchitis and bronchiectasis.
Spirometry - restrictive type respiratory failure.
Blood gazes – hypoxemia and hypercapnia, decreased oxygen
saturation.
Complications
Right heart failure very rare pneumothorax.
Pulmonary emphysema, chronic bronchitis and bronchiectasis
Bronchiectases
Definition: local dilatation of the bronchi
Predisposition factors
Chronic bronchitis, pneumonia, congenital (cystic fibrosis)
Symptoms
Cough with much sputum, especially in the morning and breath odor.
The sputum is
in three levels – upper foam-like, middle – mucous, lower – purulent,
occasionally
haemoptysis (blood in the sputum)
During exacerbation the same as in acute bronchitis, but more severe,
nearer to
pneumonia
Physical examination
Mainly in auscultation - decreased vesicular breathing with ronchi, which
are resonant,
when there is inflammation of the parenchyma
Occasionally clubbing of the fingers
Lab tests
Increased WBC(3,5-5,5) and sedimentation rate(in men 5-15-in women
8-20)
Microbiology
Sputum culture
Radiology
Increased lung markings, stretching to the periphery of the lung
CAT - cylindrical or sack-like dilatations of the bronchi.
Spirometry
Occasionally restrictive type respiratory failure
Blood gases hypoxemia, sometimes with hypercapnia
Complications
Acute- Local: pneumonia, pulmonary abscesses
General: myocarditis, pericarditis, endocarditis, encephalitis, meningitis,
sepsis;
, Chronic- Local: pneumofibrosis, pulmonary emphysema
General: amyloidosis
30) Bronchiectases
Definition: local dilatation of the bronchi
Predisposition factors
Chronic bronchitis, pneumonia, congenital (cystic fibrosis)
Symptoms
Cough with much sputum, especially in the morning and breath odor.
The sputum is
in three levels – upper foam-like, middle – mucous, lower – purulent,
occasionally
haemoptysis (blood in the sputum)
During exacerbation the same as in acute bronchitis, but more severe,
nearer to
pneumonia
Physical examination
Mainly in auscultation - decreased vesicular breathing with ronchi, which
are resonant,
when there is inflammation of the parenchyma
Occasionally clubbing of the fingers
Lab tests
Increased WBC(3,5-5,5) and sedimentation rate(in men 5-15-in women 8-
20)
Microbiology
Sputum culture
Radiology
Increased lung markings, stretching to the periphery of the lung
CAT - cylindrical or sack-like dilatations of the bronchi.
Spirometry
Occasionally restrictive type respiratory failure
Blood gases hypoxemia, sometimes with hypercapnia
Complications
Acute-
Local: pneumonia, pulmonary abscesses
General: myocarditis, pericarditis, endocarditis, encephalitis, meningitis,
sepsis;
Chronic-
Local: pneumofibrosis, pulmonary emphysema
General: amyloidosis
31)Bronchial Asthma
Definition: in most cases allergic disease causing attacks of
breathlessness while exhaling
Classification: atopic and nonatopic
Ethyology and predisposition factors:
For the atopic asthma: family predisposition with increased levels of IgE
For the non-atopic type: infections - mainly pneumonia or sinusitis in
childhood
Special types of asthma:
