#11: Pulmonary Disease States 3

Question 1

etiologies of bronchiectasis: (7)

Answer 1

1- Infx (Klebsiella, MAC, mycoplasma, Staph, TB)
2- Bronchial obstruction (tumor, FB, stenosis)
3- Aspiration
4- CF and Young Syndrome
5- allergic bronchopulmonary aspergillus
6- AAT deficiency
7- Autoimmune/CT disorders (rare causes: anatomic abnormality, primary ciliary dyskinesia, congenital immune dysfx)

Question 2

MC epidemiology of bronchiectasis:

Answer 2

• > 60 y.o.
• caucasian
• females
• thin/slender
• MC primary dz w/ MAC (Lady Windermere dz)

Question 3

Pathophysiology associated w/ Bronchiectasis: (3)

Answer 3

1- permanent dilation of the proximal and medium sized bronchi (due to destruction of bronchial walls)
2- progressive inability to clear secretions and resolve colonization or repeated infx
3- Chronic airway obstructive dz

Question 4

SXS of bronchiectasis: (8)

Answer 4

1- cough (common w/ hemoptysis)
2- dyspnea
3- daily muculopurulent sputum
4- fever
5- pleuritic CP
6- wheezing
7- weight loss
8- weakness

Question 5

Imaging of choice in bronchiectasis:

Answer 5

HRCT with contrast

Question 6

Mainstay tx modalities for bronchiectasis for sxs tx:

Answer 6

abx and chest physiotherapy

- others may include bronchodilators, corticosteroids, diertary supplementation, oxygen and surgery

Question 7

Bronchiectasis defined as exacerbation and tx:

Answer 7

• increased and more viscous sputum with foul odor

- hospital admission, IV abx and supplemental nutrition

Question 8

surfactant production in the fetus begins at:

Answer 8

32-34 wks

Question 9

surfactant production becomes sufficient at:

Answer 9

34-36 wks

Question 10

Type 2 alveolar cell growth begins at:

Answer 10

20 wks

Question 11

Fetal lung maturation can be assessed via:

Answer 11

testing amniotic fluid for lecithin levels

Question 12

What would decrease surfactant levels: (5)

Answer 12

1- hypovolemia
2- hypothermia
3- hypoxemia
4- acidosis
5- rare genetic disorders

Question 13

RDS risk factors: (9)

Answer 13

1- *MC: prematurity (1/3 between 28-32 wks)
2- asphyxia
3- CS w/o labor
4- caucasian
5- fetal distress
6- male
7- maternal DM
8- previous premie w/ RDS
9- 2nd of twins