Bronchiectasis Flashcards
define bronchiectasis?
Dilated bronchi with mucus
what are the overall causes for bronchiectasis?
recurrent infections
systemic inflammatory conditions.
how does a weak immune system cause bronchiectasis?
-steps
Weak immune system –> recurrent infection –> bronchial wall inflamed; mucus made + proteases destroy elastin causing dilated bronchi –> mucociliary dyskinesia –> mucus not cleared –> infection still there –> more inflammation –> and so and so forth
which cells make mucus in lungs?
what happens to these cells in bronchiectasis?
Goblet cells
hypertrophy
most common infective organism leading to bronchiectasis?
Haemophilus influenzae
which two congenital conditions can cause bronchiectasis?
Cystic fibrosis
Kartagener’s syndrome
pattern on spirometry?
why?
obstructive
Mucus obstructs airways
on auscultation, you hear a low pitched snore sound.
what is this called?
what is causing it?
Rhonchi
mucus moving in airways
symptoms of bronchiectasis?
Cough
Sputum
SOB
Haemoptysis
on coughing along with sputum what else might their be?
why does this happen?
blood
Lung damaged –> lungs try to heal by growing new vasculature –> new vessels are fragile + you cough from infection –> cough up blood
pt h
pt has bronchiectasis
why is there weight loss & Malaise?
ongoing inflammation requires calories
pt has bronchiectasis
MSK signs on examination?
Clubbing
pt has bronchiectasis
what do you hear on auscultation?
Coarse crackles
Wheeze
Rhonchi
diagnostic IX for bronchiectasis?
hallmark features on this Ix?
-2
CT
signet rings + tram tracks
pt has bronchiectasis.
you do CXR although it is not diagnostic.
why?
rule out other causes
pt has bronchiectasis.
how do you screen for CF?
Sweat chloride test
pt has bronchiectasis.
apart from imaging.
what Ix do you do and why?
-3
sweat chloride test – screens CF
Sputum culture – check pathogen
Spirometry – see obstructive pattern
1st line Mx for pts with bronchiectasis?
-4
(note: 3 of them are not medicinal)
Breathing exercises
postural drainage
Get vaccinated
Antibiotics – for infective exacerbations
second line drugs for pts with bronchiectasis?
-2
(one of them really isn’t drug)
effect of giving these things
Carbocisteine - ↓sputum viscosity
Saline - sputum more runny so easier to cough
non medical and now medical Mx have failed.
what is 3rd line Mx?
Lung transplant
give e.g. of a mucolytic?
Carbocisteine
