NRNP 6531 What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years?

NRNP 6531What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years?

answer:

Chronic bronchitis is a clinical diagnosis characterized by a cough productive of sputum for over three months’ duration during two consecutive years and the presence of airflow obstruction. Pulmonary function testing aids in the diagnosis of chronic bronchitis by documenting the extent of reversibility of airflow obstruction. A better understanding of the role of inflammatory mediators in chronic bronchitis has led to greater emphasis on management of airway inflammation and relief of bronchospasm. Inhaled ipratropium bromide and sympathomimetic agents are the current mainstays of management. While theophylline has long been an important therapy, its use is limited by a narrow therapeutic range and interaction with other agents. Oral steroid therapy should be reserved for use in patients with demonstrated improvement in airflow not achievable with inhaled agents. Antibiotics play a role in acute exacerbations but have been shown to lead to only modest airflow improvement. Strengthening of the respiratory muscles, smoking cessation, supplemental oxygen, hydration and nutritional support also play key roles in long-term management of chronic bronchitis.

Chronic bronchitis is one of the principal manifestations of chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the United States. About 10 million Americans are affected by some degree of COPD; it causes 40,000 deaths annually.1

Chronic bronchitis is a clinical diagnosis characterized by a cough productive of sputum for over three months’ duration during two consecutive years and airflow obstruction. These requisites exclude more transient causes of cough associated with sputum production, such as acute bronchitis. The airflow obstruction in chronic bronchitis is caused by excessive tracheobronchial mucus production and is distinct from the anatomic findings of distal air space distention and alveolar septa destruction, which define emphysema.2

Cigarette smoking is the most important risk factor for the development of chronic bronchitis. Over 90 percent of patients with chronic bronchitis have a smoking history, although only 15 percent of all cigarette smokers are ultimately diagnosed with some form of obstructive airway disease.1 Studies have demonstrated persistent markers of active airway inflammation in bronchial biopsy specimens from symptomatic ex-smokers, even after they had been smoke-free for 13 years.2

The overall 10-year mortality rate following the diagnosis of chronic bronchitis is 50 percent,3 with respiratory failure following an acute exacerbation being the most frequent terminal event. Such acute exacerbations are often precipitated by bacterial infection, manifested by purulent sputum, fever and a worsening of the symptoms of poor ventilation. Other known precipitants include viral upper respiratory infections, seasonal changes in the weather, medications and exposure to irritant inhalants.

question:

NRNP 6531What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years?

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