Bronchiectasis

Question 1

Definition

Answer 1

Abnormal destruction and dilation id large airways.
Bronchi -> inflamed, widened enlarged -> lung secretion and mucus does not pass through and accumulate-> cause infection and production of increased amount of sputum

Question 2

Classification

Answer 2

Based on pathological and bronchographic appearance

1. Cylindrical
2. Varicose
3. Cystic

1) congenital : lung periphery fails to develop and results in cystic dilation of developed bronchi
2) acquired: direct destruction of bronchi wall causes bronchial dilation and secondary infection

Question 3

Causes

Answer 3

Impaired microciliary function impaired immunity 
Acute necrotic pneumonia 
Persistent infection of aspergilus 
Bronchial obstruction 
Inhalation of corrosive material

Question 4

Complaints

Answer 4

Chronic cough
Sputum production (mucus or mucopurulent / hemoptysis )
Recurrent fever with or without pneumonia
Shortness of breath
Weakness and fatigue

Question 5

examination

Answer 5

Central cyanosis
Withered skin, fragile hair, weight loss, digital clubbing , hypertrophic pulmonary osteothropathy
Barrel chest

Hyper resonance over lungs
Tympanic over bronchi

Rough breath sound medium or large bubbling rhonchi
Sometimes diffuse high pitch wheezes

TF decreases but it may increase over bronchiectasis
Elasticity decreases

RV hypertrophy

Question 6

Investigations

Answer 6

Blood :
Increase leukocytosis and left shift
Increased ESR later anemia

Sputum:
Muco purulent / purulent 
3 layers 
Frothy top 
Greenish turbid middle
Thick pus bottom 
Sometimes elastic fibers 
Neutrophils increased plus erythrocytes

Question 7

Treatment

Answer 7

Antibiotics 
Bronchodilators 
Anti inflammatory therapy 
Surgery 
Postural drainage