Chronic bronchitis laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Chronic obstructive pulmonary disease can be diagnostically evaluated by physical examination through auscultation. Physical examination are quite specific and sensitive for severe disease. The signs are usually difficult to detect in cases of mild to moderate diseases. Findings on general physical examination can be cyanosis, tachypnea, use of accessory respiratory muscles, paradoxical indrawing of lower intercostal spaces is evident (known as the Hoover sign), elevated jugular venous pulse and peripheral edema. Pulmonary examination in can be barrel chest (emphysema), wheezing, hyperresonance, crackles and rhonchi
Lab tests
A variety of tests may be performed in patients presenting with cough and shortness of breath:
- Pulmonary Function Tests (PFT) (or spirometry) must be performed in all patients presenting with chronic cough. An FEV1/FVC ratio below 0.7 that is not fully reversible after bronchodilator therapy indicates the presence of COPD, that requires more aggressive therapy and carries a more severe prognosis than simple chronic bronchitis.
- A sputum sample showing neutrophil granulocytes (inflammatory white blood cells) and culture showing that has pathogenic microorganisms such as Streptococcus spp.
- A blood test would indicate inflammation (as indicated by a raised white blood cell count and elevated C-reactive protein).
- Neutrophils infiltrate the lung tissue, aided by damage to the airways caused by irritation.
- Damage caused by irritation of the airways leads to inflammation and leads to neutrophils being present
- Mucosal hypersecretion is promoted by a substance released by neutrophils
- Further obstruction to the airways is caused by more goblet cells in the small airways. This is typical of chronic bronchitis
- Although infection is not the reason or cause of chronic bronchitis it is seen to aid in sustaining the bronchitis.