Bronchiectasis Flashcards

1
Q

define bronchiectasis?

A

Dilated bronchi with mucus

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2
Q

what are the overall causes for bronchiectasis?

A

recurrent infections

systemic inflammatory conditions.

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3
Q

how does a weak immune system cause bronchiectasis?

-steps

A

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

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4
Q

which cells make mucus in lungs?

what happens to these cells in bronchiectasis?

A

Goblet cells

hypertrophy

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5
Q

most common infective organism leading to bronchiectasis?

A

Haemophilus influenzae

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6
Q

which two congenital conditions can cause bronchiectasis?

A

Cystic fibrosis

Kartagener’s syndrome

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7
Q

pattern on spirometry?

why?

A

obstructive

Mucus obstructs airways

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8
Q

on auscultation, you hear a low pitched snore sound.

what is this called?

what is causing it?

A

Rhonchi

mucus moving in airways

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9
Q

symptoms of bronchiectasis?

A

Cough
Sputum
SOB
Haemoptysis

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10
Q

on coughing along with sputum what else might their be?

why does this happen?

A

blood

Lung damaged –> lungs try to heal by growing new vasculature –> new vessels are fragile + you cough from infection –> cough up blood

pt h

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11
Q

pt has bronchiectasis

why is there weight loss & Malaise?

A

ongoing inflammation requires calories

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12
Q

pt has bronchiectasis

MSK signs on examination?

A

Clubbing

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13
Q

pt has bronchiectasis

what do you hear on auscultation?

A

Coarse crackles
Wheeze
Rhonchi

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14
Q

diagnostic IX for bronchiectasis?

hallmark features on this Ix?
-2

A

CT

signet rings + tram tracks

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15
Q

pt has bronchiectasis.

you do CXR although it is not diagnostic.
why?

A

rule out other causes

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16
Q

pt has bronchiectasis.

how do you screen for CF?

A

Sweat chloride test

17
Q

pt has bronchiectasis.

apart from imaging.

what Ix do you do and why?
-3

A

sweat chloride test – screens CF
Sputum culture – check pathogen
Spirometry – see obstructive pattern

18
Q

1st line Mx for pts with bronchiectasis?
-4

(note: 3 of them are not medicinal)

A

Breathing exercises
postural drainage
Get vaccinated
Antibiotics – for infective exacerbations

19
Q

second line drugs for pts with bronchiectasis?
-2
(one of them really isn’t drug)

effect of giving these things

A

Carbocisteine - ↓sputum viscosity

Saline - sputum more runny so easier to cough

20
Q

non medical and now medical Mx have failed.

what is 3rd line Mx?

A

Lung transplant

21
Q

give e.g. of a mucolytic?

A

Carbocisteine