Path Chronic Bronchitis

Chronic bronchitis (definition)

Chronic productive cough lasting at least 3 months in each of two consecutive years after other causes of chronic cough have been excluded.

Diseases that must be ruled out before diagnosing chronic bronchitis

Asthma, GERD, postnasal drip, tuberculosis, lung cancer.

Chronic bronchitis classification

A type of chronic obstructive pulmonary disease (COPD).

Primary airways affected in chronic bronchitis

Conducting airways, especially the bronchi.

Epidemiology of chronic bronchitis

Common in middle-aged and older adults, especially cigarette smokers and individuals exposed to pollutants.

Major cause of chronic bronchitis

Cigarette smoking

Other etiologic factors of chronic bronchitis

Air pollution, occupational dust or toxic gases, recurrent infections, family history.

Primary pathophysiologic process in chronic bronchitis

Chronic inflammation of the airways with excessive mucus production.

Goblet cell changes in chronic bronchitis

Goblet cell hyperplasia.

Submucosal gland changes in chronic bronchitis

Enlargement of mucus-secreting glands.

Result of mucus hypersecretion

Airway obstruction and mucus plugging.

Effect of inflammation on mucociliary clearance

Decreased ciliary function and impaired mucus elimination.

Airway wall changes in chronic bronchitis

Chronic inflammation and thickening.

Bronchospasm in chronic bronchitis

Smooth muscle constriction of the bronchial airways.

Late-stage lung changes in chronic bronchitis

Air trapping and alveolar hyperinflation.

Primary gas exchange abnormality in chronic bronchitis

Ventilation-perfusion mismatch leading to hypoxemia.

Typical cough in chronic bronchitis

Chronic productive cough.

Common breath sounds in chronic bronchitis

Coarse crackles and expiratory wheezes.

Sputum characteristics in chronic bronchitis

Thick, copious sputum.

Typical patient appearance in chronic bronchitis

Cyanotic ("blue bloater").

Cause of cyanosis in chronic bronchitis

Chronic hypoxemia.

Blood abnormality commonly seen in chronic bronchitis

Polycythemia due to chronic hypoxia.

Cardiac complication of chronic bronchitis

Cor pulmonale (right-sided heart failure).

Signs of cor pulmonale

Peripheral edema, jugular vein distention.

DLCO in chronic bronchitis

Usually normal.

PFT findings in chronic bronchitis

Decreased expiratory flow rates, normal to increased residual volume.

Acute exacerbation of chronic bronchitis definition

An abrupt worsening of symptoms.

Symptoms of acute exacerbation

Increased dyspnea, increased sputum volume, increased sputum purulence.

Airway changes during exacerbation

Edema, hyperemia, mucus plugging, impaired airflow.

Goals of treatment for chronic bronchitis

Relieve symptoms, prevent complications, slow disease progression.

Short-term management of chronic bronchitis

Oxygen therapy, bronchial hygiene, medications.

Bronchial hygiene techniques

Postural drainage, hydration, deep breathing and coughing.

Bronchodilators used in chronic bronchitis

Short-acting and long-acting bronchodilators.

Anti-inflammatory medications used

Inhaled corticosteroids.

Other medications used in chronic bronchitis

Methylxanthines, antibiotics, phosphodiesterase-4 inhibitors.

Ventilatory support options

Noninvasive ventilation or mechanical ventilation.

Most important long-term treatment

Smoking cessation.

Effect of smoking cessation on lung function

Decreases the rate of lung function deterioration.

Vaccines recommended for chronic bronchitis

Annual influenza vaccine and pneumococcal vaccine.

Role of pulmonary rehabilitation

Improves exercise tolerance and quality of life.

Nutrition recommendation

Well-balanced diet to maintain ideal body weight.

Education topics for patients with chronic bronchitis

Disease process, medications, pulmonary hygiene, infection control.

Nickname for chronic bronchitis COPD type

Blue bloater (Type B COPD).