Acute bronchitis

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????? ???????????? ???.????????????????
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Acute bronchitis
?????????????????? bronchi ?? lower respiratory
tract ?????????????? ??? streptococcus pneumonie,
haemophilus influenza, mycoplasma pneumonie,
chlamydia p.
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?????????????????

• cough
• sputum clear, mucoid, purulent
• fever
• headache
• malaise
• shortness of breathing

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physical examination

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

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Treatment

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

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Pneumonia

• ??????????????????????????????????????????????????
  ??????? ????????????????????????????????????????
• aspirate
• inhalation
• hematogenous spred

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Factors predisposing to pneumonia

• aging
• air pollution
• altered consciousness
• bed rest and prolong immobility
• chronic disease
• HIV

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Factors predisposing to pneumonia

• immunosuppressive drugs
• inhalation or aspirate of noxious sub
• intestinal and gastric feeding
• malnutrition
• smoking
• tracheal intubation

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Type of pneumonia

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

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Type of pneumonia

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

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Pathophysiology

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

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Pathophysiology

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

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?????????????????

• ?????? ???????? ?????????
• ????????????????????????????????
• ??????? ??????????????? ????????
• ???????? ????????????????????
• ????????? ???????? ????????
• ??

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?????????????????

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

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???????????

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

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??????????

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

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??????????????????

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

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Tuberculosis

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

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?????????????????

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

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??????????????????

• ??????? TB
• isoniazid,rifampin,pyrazinamide
• streptomycin or eythambutol

• ethionamide,capremycin,kanamycin,
• para-aminosalicylic acid,cycloserine

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??????????????????

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

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????????????????????????????????????????

• ??????????????????????????????????????????????
• ?????????????????????????????????????????????
• ????????????????????????????????????
• ??????????????????????????????????????????
• ?????????????????????????
• ?????????????????????????????

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