284 Bronchiectasis

Question 1

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

Answer 1

bronchiectasis

Question 2

Types of bronchiectasis

Answer 2

cylindrical or tubular, varicose, cystic

Question 3

most common form of bronchiectasis

Answer 3

tubular or cylindrical

Question 4

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

Answer 4

focal bronchiectasis

Question 5

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

Answer 5

diffuse bronchiectasis

Question 6

conditions leading to pronounced bronchiectasis in the upper lung fields

Answer 6

cystic fibrosis and postradiation

Question 7

causes bronchietasis in the lower long fields

Answer 7

chronic recurrent aspiration

Question 8

bronchiectasis that predominantly affects midlung fields

Answer 8

MAC infection

Question 9

congenital disorder that causes bronchiectasis in the midlung

Answer 9

dyskinetic or immotile cilia syndrome

Question 10

bronchiectasis that involves the central airways

Answer 10

allergic bronchopulmonary aspergillosis

Question 11

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

Answer 11

Mounier Kuhn syndrome and Williams Campell syndrome

Question 12

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

Answer 12

True.

Question 13

most widely cited mechanism of infectious bronchiectasis

Answer 13

vicious cycle hypothesis

Question 14

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

Answer 14

Pseudomonas aeruginosa

Question 15

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

Answer 15

Alpha 1 antitrypsin

Question 16

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

Answer 16

traction bronchiectasis

Question 17

most common clinical manifestation of bronchiectasis

Answer 17

persistent productive cough with ongoing production of thick tenacious sputum

Question 18

characterized acute exacerbations of bronchiectasis

Answer 18

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

Question 19

indicate dilated airways on chest x-ray consistent with bronchiectasis

Answer 19

tram tracks

Question 20

more specific diagnostic imaging for bronchiectasis than chest x-ray

Answer 20

chest CT

Question 21

CT scan finding of bronchiectasis

Answer 21

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

Question 22

diameter that you can say airway is dilated

Answer 22

more than 1.5 times the diameter of the adjacent vessel

Question 23

associated with the tree-in-bud pattern

Answer 23

bronchiectasis

Question 24

what is tree-in-bud pattern

Answer 24

bronchial wall thickening in dilated airways inspissated secretions

Question 25

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

Answer 25

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

Question 26

when should NTM treatment be started

Answer 26

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

Question 27

most common NTM pathogen

Answer 27

MAC

Question 28

treatment for MAC HIV negative patient with macrolide sensitive MAC

Answer 28

macrolide combined with rifampicin and ethambutol

Question 29

recommended routinely for CF related bronchiectasis for bronchial hygeine

Answer 29

mucolytic dornase

Question 30

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

Answer 30

cystic fibrosis

Question 31

gene responsible for CF

Answer 31

cystic fibrosis transmembrance conductance regular

Question 32

what does CFTR do

Answer 32

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

Question 33

conditions in bronchiectasis where glucocorticoids may be given

Answer 33

bronchiectasis from ABPA

Question 34

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

Answer 34

itraconazole

Question 35

treatment of refractory cases of bronchiectasis

Answer 35

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

Question 36

decline of pulmonary function in non CF bronchiectasis

Answer 36

FEV1 declining by 50-55 ml per year

Question 37

possible suppressive treatments in bronchiectasis

Answer 37

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

Question 38

macrolisde associated with decreasing rates of bronchiectasis excerbation

Answer 38

azithromycin or erythromycin

Question 39

side effect to watch out for in patients on macrolide

Answer 39

prolonged QT interval