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Pulmonology > 284 Bronchiectasis > Flashcards

284 Bronchiectasis Flashcards

1
Q

refers to an irreversible airway dilatation that involves the lung in either a focal or a diffuse manner

A

bronchiectasis

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2
Q

Types of bronchiectasis

A

cylindrical or tubular, varicose, cystic

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3
Q

most common form of bronchiectasis

A

tubular or cylindrical

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4
Q

refers to bronchiectatic changes in a localized area of the lung and can be a consequence of obstruction in the airway

A

focal bronchiectasis

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5
Q

characterized by a widespread bronchiectatic changes throughout the lungs and often arises from an underlying systemic or infectious disease process

A

diffuse bronchiectasis

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6
Q

conditions leading to pronounced bronchiectasis in the upper lung fields

A

cystic fibrosis and postradiation

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7
Q

causes bronchietasis in the lower long fields

A

chronic recurrent aspiration

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8
Q

bronchiectasis that predominantly affects midlung fields

A

MAC infection

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9
Q

congenital disorder that causes bronchiectasis in the midlung

A

dyskinetic or immotile cilia syndrome

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10
Q

bronchiectasis that involves the central airways

A

allergic bronchopulmonary aspergillosis

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11
Q

congenital cause of congenital airway predominant bronchiectasis resulting from cartilage deficienct include tracheobroncomegaly

A

Mounier Kuhn syndrome and Williams Campell syndrome

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12
Q

True or false. Bronchiectasis is more common in women than in men

A

True.

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13
Q

most widely cited mechanism of infectious bronchiectasis

A

vicious cycle hypothesis

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14
Q

organism with particular propensity for colonizing damaged airwats and evading host defense mechanism

A

Pseudomonas aeruginosa

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15
Q

play an important role in neutralizing the damaging effects of neutrophil elastase and enhancing bacterial killing

A

Alpha 1 antitrypsin

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16
Q

refers to dilated airways arising from parenchymal distortion as a result of lung fibrosis

A

traction bronchiectasis

17
Q

most common clinical manifestation of bronchiectasis

A

persistent productive cough with ongoing production of thick tenacious sputum

18
Q

characterized acute exacerbations of bronchiectasis

A

changes in the nature of sputum production, with increased volume and purulence

19
Q

indicate dilated airways on chest x-ray consistent with bronchiectasis

A

tram tracks

20
Q

more specific diagnostic imaging for bronchiectasis than chest x-ray

A

chest CT

21
Q

CT scan finding of bronchiectasis

A

airway dilations seen as parallel tram tracks or as signet ring sign, cross section area of the airway with a diameter of at least 1.5 times that of the adjacent vessel

22
Q

diameter that you can say airway is dilated

A

more than 1.5 times the diameter of the adjacent vessel

23
Q

associated with the tree-in-bud pattern

A

bronchiectasis

24
Q

what is tree-in-bud pattern

A

bronchial wall thickening in dilated airways inspissated secretions

25
Q

How long should antibiotics be given if causative pathogens are H Influenzae and P Aeruginosa

A

minimum of 7-10 days and as long as 14 days

26
Q

when should NTM treatment be started

A

when at least two sputum samples positive on culture, at least one BAL sample positive on culture

27
Q

most common NTM pathogen

A

MAC

28
Q

treatment for MAC HIV negative patient with macrolide sensitive MAC

A

macrolide combined with rifampicin and ethambutol

29
Q

recommended routinely for CF related bronchiectasis for bronchial hygeine

A

mucolytic dornase

30
Q

autosomal recessive exocrinopathy affecting multiple epithelial tissues that can lead to bronchiectasis

A

cystic fibrosis

31
Q

gene responsible for CF

A

cystic fibrosis transmembrance conductance regular

32
Q

what does CFTR do

A

anion channel in the apical plasma membrane of epithelial cells and regulates volume and composition of exocrine secretions

33
Q

conditions in bronchiectasis where glucocorticoids may be given

A

bronchiectasis from ABPA

34
Q

patients with ABPA may also benefit from prolonged treatment of this drug

A

itraconazole

35
Q

treatment of refractory cases of bronchiectasis

A

resection of focal area of suppuration; in advanced cases, lung transplantation

36
Q

decline of pulmonary function in non CF bronchiectasis

A

FEV1 declining by 50-55 ml per year

37
Q

possible suppressive treatments in bronchiectasis

A
  1. ciprofloxacin daily for 1-2 weeks per month, 2. use of rotating schedule of oral antibiotics, 3. administration of macrolide antibiotics daily or 3x per week, 4. inhalation of aerosolized antibiotics on rotating schedule 30 days on, 30 days off, 5. intermittent administration of IV antibiotics
38
Q

macrolisde associated with decreasing rates of bronchiectasis excerbation

A

azithromycin or erythromycin

39
Q

side effect to watch out for in patients on macrolide

A

prolonged QT interval

Pulmonology (9 decks)

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