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Acute bronchitis

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Title: PowerPoint Author: com Last modified by: CasperX Created Date: 6/25/2005 7:02:51 AM Document presentation format – PowerPoint PPT presentation

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Title: Acute bronchitis


1
????????????????????????????????????????????
????? ???????????? ???.????????????????
2
Acute bronchitis
?????????????????? bronchi ?? lower respiratory
tract ?????????????? ??? streptococcus pneumonie,
haemophilus influenza, mycoplasma pneumonie,
chlamydia p.
3
?????????????????
  • cough
  • sputum clear, mucoid, purulent
  • fever
  • headache
  • malaise
  • shortness of breathing

4
physical examination
  • fever
  • pulse,respiration rate normal
  • rhonchi, wheezing
  • x-ray infiltration

5
Treatment
  • self-limiting
  • fluid
  • rest
  • cough suppressant agent
  • bronchodilator

6
Pneumonia
  • ??????????????????????????????????????????????????
    ??????? ????????????????????????????????????????
  • aspirate
  • inhalation
  • hematogenous spred

7
Factors predisposing to pneumonia
  • aging
  • air pollution
  • altered consciousness
  • bed rest and prolong immobility
  • chronic disease
  • HIV

8
Factors predisposing to pneumonia
  • immunosuppressive drugs
  • inhalation or aspirate of noxious sub
  • intestinal and gastric feeding
  • malnutrition
  • smoking
  • tracheal intubation

9
Type of pneumonia
  • Community-Acquired pneumonia CAP
  • ?????????????????????????????????????????????????
    ??.????????? 2 ???
  • ??????????????????????????
  • ?????????????????????????????
  • ????????????????? streptococcus p.
  • ????????? doxycyclin

10
Type of pneumonia
  • Hospital-Acquired pneumpnia HAP
  • ???????????????????????????? 48 ??. ???????????
  • ???????????????????????? Pseudomonase,enterobacte
    r S. aures
  • ????????? aminoglycoside,cefoperazone
  • impenam,aztreonam,vancomycin

11
Pathophysiology
  • congestion ???????????????????????????? 12- 24
    ??.???????????????????????????????????????????????
    ????????????????????? ?????????????????????
    ?????????????????? ???????????? transudate,
    exudate
  • red haptization ???????????? 2-3
    ????????????????????????????????????
    ??????????????????????????

12
Pathophysiology
  • gray hepatization ???????????? 4-5
    ?????????????????????????????? ???????????????????
    ????????????????? ??????????????????????????????
  • resolution ????????????????????? 7-10
    ????????????????????????????????????????????????

13
?????????????????
  • ?????? ???????? ?????????
  • ????????????????????????????????
  • ??????? ??????????????? ????????
  • ???????? ????????????????????
  • ????????? ???????? ????????
  • ??

14
?????????????????
  • ????????????????? crepitation
  • ????????????????? pleural friction rub
  • ????????????????????????

15
???????????
  • ???????????????? ?????????????? ???????????
  • ???????????????????????? sputum
  • ???????????????????? infiltration
  • ?????????????? (hemoculture)

16
??????????
  • Pneumococcal vaccine ????????????????????????????
  • chronic illness
  • recovering from severe illness
  • 65 year or older
  • in long term care

17
??????????????????
  • ???????? antibiotic, antiviral
  • amantadine,rimantadine
  • 0xygen therapy
  • analgesic antipyretic drugs
  • rest

18
Tuberculosis
  • ???????????? Mycobacterium T.
  • ?????????????????????? airborne dropletes
  • ?????????????? closed contact
  • ?????????????????????????????????????????????????
  • ?????????????????????????????????? epithelium
    granuloma

19
?????????????????
  • ??????????????????????
  • ?????? ?????????? ?????????
  • ??????????
  • ??????????? (advance case)
  • pleuritic chest pain
  • pneumocyctic carinii p.(PCP)

20
??????????????????
  • ??????? TB
  • isoniazid,rifampin,pyrazinamide
  • streptomycin or eythambutol
  • ethionamide,capremycin,kanamycin,
  • para-aminosalicylic acid,cycloserine

21
??????????????????
  • quinolone,ciprofloxacin,ofloxacin,
  • sparfloxacin,rifapetine
  • long term care
  • bacille calmette guerin (BCG)

22
????????????????????????????????????????
  • ??????????????????????????????????????????????
  • ?????????????????????????????????????????????
  • ????????????????????????????????????
  • ??????????????????????????????????????????
  • ?????????????????????????
  • ?????????????????????????????

23
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