Anthony Miller, a 59-year-old male, presents to the clinic with complaints of cough, shortness of breath, and increased
Posted: Sun Feb 13, 2022 8:55 am
Anthony Miller, a 59-year-old male, presents to the clinic with
complaints of cough, shortness of breath, and increased sputum
production. His past medical history is significant for COPD with
chronic bronchitis, hypertension, diabetes, and hyperlipidemia. He
reports that his sputum has increased in consistency and amount
over the past few days. His last exacerbation was about 6 months
ago, for which he received amoxicillin. This is his third
exacerbation in the past year. He has a 40-pack year history of
cigarette smoking and quit smoking 3 years ago. He does not take
chronic steroids. Physical reveals rhonchi and expiratory wheezes.
His vital signs are blood pressure 140/83 mm Hg, pulse rate 80
beats/min, respiration rate 20 breaths/min, and temperature 98.8°F.
He has no known drug allergies. A sputum Gram stain in the office
reveals purulent sputum (presence of WBCs). Chest x-ray findings
are negative for pneumonia.
Diagnosis: Acute Exacerbation of Chronic Bronchitis
Please provide your rationales for each answer with supporting
data Which of the following would suggest the need for antibiotic
therapy in A.M.?
Cough, history of smoking, and expiratory wheezes
Elevated respiratory rate and shortness of breath Increased
dyspnea,
increased sputum production, and increased sputum purulence
History of previous COPD exacerbations, cough, and fever
What is a likely pathogen associated with an acute exacerbation
of chronic bronchitis in A.M.?
Mycobacterium tuberculosis
Pseudomonas aeruginosa
Staphylococcus aureus
Streptococcus pneumonia
What antibiotic would be most appropriate to treat an acute
exacerbation of chronic bronchitis in A.M.?
Amoxicillin–clavulanate
Azithromycin Linezolid
Sulfamethoxazole/trimethoprim
What is the mechanism of action of the medication of choice in
question #3? Provide rationale.
What kind of counseling points would you provide for A.M.?
complaints of cough, shortness of breath, and increased sputum
production. His past medical history is significant for COPD with
chronic bronchitis, hypertension, diabetes, and hyperlipidemia. He
reports that his sputum has increased in consistency and amount
over the past few days. His last exacerbation was about 6 months
ago, for which he received amoxicillin. This is his third
exacerbation in the past year. He has a 40-pack year history of
cigarette smoking and quit smoking 3 years ago. He does not take
chronic steroids. Physical reveals rhonchi and expiratory wheezes.
His vital signs are blood pressure 140/83 mm Hg, pulse rate 80
beats/min, respiration rate 20 breaths/min, and temperature 98.8°F.
He has no known drug allergies. A sputum Gram stain in the office
reveals purulent sputum (presence of WBCs). Chest x-ray findings
are negative for pneumonia.
Diagnosis: Acute Exacerbation of Chronic Bronchitis
Please provide your rationales for each answer with supporting
data Which of the following would suggest the need for antibiotic
therapy in A.M.?
Cough, history of smoking, and expiratory wheezes
Elevated respiratory rate and shortness of breath Increased
dyspnea,
increased sputum production, and increased sputum purulence
History of previous COPD exacerbations, cough, and fever
What is a likely pathogen associated with an acute exacerbation
of chronic bronchitis in A.M.?
Mycobacterium tuberculosis
Pseudomonas aeruginosa
Staphylococcus aureus
Streptococcus pneumonia
What antibiotic would be most appropriate to treat an acute
exacerbation of chronic bronchitis in A.M.?
Amoxicillin–clavulanate
Azithromycin Linezolid
Sulfamethoxazole/trimethoprim
What is the mechanism of action of the medication of choice in
question #3? Provide rationale.
What kind of counseling points would you provide for A.M.?