284 Bronchiectasis Flashcards
refers to an irreversible airway dilatation that involves the lung in either a focal or a diffuse manner
bronchiectasis
Types of bronchiectasis
cylindrical or tubular, varicose, cystic
most common form of bronchiectasis
tubular or cylindrical
refers to bronchiectatic changes in a localized area of the lung and can be a consequence of obstruction in the airway
focal bronchiectasis
characterized by a widespread bronchiectatic changes throughout the lungs and often arises from an underlying systemic or infectious disease process
diffuse bronchiectasis
conditions leading to pronounced bronchiectasis in the upper lung fields
cystic fibrosis and postradiation
causes bronchietasis in the lower long fields
chronic recurrent aspiration
bronchiectasis that predominantly affects midlung fields
MAC infection
congenital disorder that causes bronchiectasis in the midlung
dyskinetic or immotile cilia syndrome
bronchiectasis that involves the central airways
allergic bronchopulmonary aspergillosis
congenital cause of congenital airway predominant bronchiectasis resulting from cartilage deficienct include tracheobroncomegaly
Mounier Kuhn syndrome and Williams Campell syndrome
True or false. Bronchiectasis is more common in women than in men
True.
most widely cited mechanism of infectious bronchiectasis
vicious cycle hypothesis
organism with particular propensity for colonizing damaged airwats and evading host defense mechanism
Pseudomonas aeruginosa
play an important role in neutralizing the damaging effects of neutrophil elastase and enhancing bacterial killing
Alpha 1 antitrypsin
refers to dilated airways arising from parenchymal distortion as a result of lung fibrosis
traction bronchiectasis
most common clinical manifestation of bronchiectasis
persistent productive cough with ongoing production of thick tenacious sputum
characterized acute exacerbations of bronchiectasis
changes in the nature of sputum production, with increased volume and purulence
indicate dilated airways on chest x-ray consistent with bronchiectasis
tram tracks
more specific diagnostic imaging for bronchiectasis than chest x-ray
chest CT
CT scan finding of bronchiectasis
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
diameter that you can say airway is dilated
more than 1.5 times the diameter of the adjacent vessel
associated with the tree-in-bud pattern
bronchiectasis
what is tree-in-bud pattern
bronchial wall thickening in dilated airways inspissated secretions
How long should antibiotics be given if causative pathogens are H Influenzae and P Aeruginosa
minimum of 7-10 days and as long as 14 days
when should NTM treatment be started
when at least two sputum samples positive on culture, at least one BAL sample positive on culture
most common NTM pathogen
MAC
treatment for MAC HIV negative patient with macrolide sensitive MAC
macrolide combined with rifampicin and ethambutol
recommended routinely for CF related bronchiectasis for bronchial hygeine
mucolytic dornase
autosomal recessive exocrinopathy affecting multiple epithelial tissues that can lead to bronchiectasis
cystic fibrosis
gene responsible for CF
cystic fibrosis transmembrance conductance regular
what does CFTR do
anion channel in the apical plasma membrane of epithelial cells and regulates volume and composition of exocrine secretions
conditions in bronchiectasis where glucocorticoids may be given
bronchiectasis from ABPA
patients with ABPA may also benefit from prolonged treatment of this drug
itraconazole
treatment of refractory cases of bronchiectasis
resection of focal area of suppuration; in advanced cases, lung transplantation
decline of pulmonary function in non CF bronchiectasis
FEV1 declining by 50-55 ml per year
possible suppressive treatments in bronchiectasis
- 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
macrolisde associated with decreasing rates of bronchiectasis excerbation
azithromycin or erythromycin
side effect to watch out for in patients on macrolide
prolonged QT interval
