7.1 CF & Bronchiectasis Flashcards

1
Q

define bronchiectasis

A

chronic irreversible dilatation of 1 or more bronchi

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2
Q

underlying mechanism of bronchiectasis

A

chronic inflammation causing destruction of elastic and muscular parts of bronchial walls, and perichondria fibrosis

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3
Q

classic CXW sign of bronchiectasis

A

tram track (thickens bronchi walls)

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4
Q

gold standard diagnostic test for bronchiectasis
-what is shown?

A

high resolution CT
shows bronchial dilation bigger than adjacent pulmonary artery (signet ring sign)

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5
Q

symptoms of bronchiectasis

A

-chronic cough
-sputum
-fatigue
-some haemoptysis
-breathless on exertion

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6
Q

signs of bronchiectasis

A

-hypoxaemia if severe
-haemoptysis
-fine crackles
-inspiratory squeaks
-fever
-rhonchi

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7
Q

2 organisms that can cause bronchiectasis and COPD

A

haemophilus influenzae
mortadella catarrhalis

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8
Q

difference in auscultation of COPD vs bronchiectasis

A

COPD
-diminshed breath sounds
-no inspiratory squeaks

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9
Q

define exacerbation of bronchiectasis

A

3 deteriorations of
-cough
-sputum volume
-blood sputum
-fatigue
-fever

for 48 hours

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10
Q

most common cause of bronchiectasis

A

CF

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11
Q

explain the mechanism of CF

A

-mutation of CFTR gene
-less Cl transported out of cells into airway, so less water follows
-produces thick and sticky mucous in airways
-impairs mucociliary clearance

-also less Na+ brought into cells via less regulation of ENaC

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12
Q

most common mutation in CF

A

Phe508del

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13
Q

intestinal malabsorption in CF can cause DM- how?

A

CF could affect the endocrine function of the pancreas

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14
Q

why are some people only diagnosed with CF in their 20s?

A

could have residual CFTR function e.g. mutation different, or heterozygous mutation

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15
Q

when to suspect atypical CF

A

-recurrent idiopathic pancreatitis
-recurrent sinusitis/lung infections
-infertility

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16
Q

list some complications of CF

A

-respiratory failure
-haemoptysis
-DM
-distal intestinal obstruction syndrome
-chronic liver disease
-gallstones
-HF
-arthritis (malabsorption of Ca2+)

17
Q

why do CF patients need to avoid each other?

A

may be colonised by different strains of pseudomonas aeruginosa so could spread antibiotic resistance

18
Q

why do CF patients need NaCl tablets in hot wetaher/exercise?

A

lose excess NaCl in their sweat

19
Q

key way to get rid of mucous in CF patients?

A

saline

20
Q

why might CF patients need a heart transplant?

A

cure cor pulmonate caused by R heart strain from years of pulmonary HTN