Bronchiectasis

Question 1

def

Answer 1

= congenital or acquired disorder of the marge bronchi characterized by permanent, abnormal dilation and destruction of bronchial walls.

Question 2

cause

Answer 2

• may be caused by recurrent inflammation or infection of the airways
• cystic fibrosis causes half of the case of bronchiecatsis

Question 3

other causes:

Answer 3

• lung infection (tuberculosis, fungal infections, lung abscess, pneumonia)
• abnormal lung defense mechanism (humoral immunodeficiency, aids, leukemia, chronic lung and hepatic diseases..)
• localized airway obstruction (foreign body, tumor)

Question 4

bronchiectasis: what does most patients have?

Answer 4

-> panhypergammaglobulinemia, presumably reflecting an immune system response to chronic airway infection

Question 5

bronchiectasis: sx

Answer 5

• chronic cough, production of copious of purulent sputum, hemoptysis and recurrent pneumonia
• wight loss, anemia, other systemic manifestations are common

Question 6

bronchiectasis: physical findings:

Answer 6

non specific:

• persistent crackles at the lungs bases, infrequent clubbing
• copious, foul smelling, purulent sputum at separates into three layers in a cup

Question 7

bronchiectasis: RX and CT scanning

Answer 7

• > RX: crowded bronchial markings related to peribronchial fibrosis and small cystic spaces at the base of the lungs
• > CT: with thin sections (1.5mm) may detect moderate to severe cases

Question 8

bronchiectasis: ttt

Answer 8

• ab: (based on the sputum smears and cultures)
• Empiric ab therapy for 10-14 days with amoxicillin 500 mg every 8h, tetracycline 250-500 mg 4 times daily
• alternating cycles of 2 or 3 ab given orally for 2-4 weeks is sometimes employed in stable bronchiectasis pt with abundant purulent sputum
• daily chest physiotherapy with postural drainage and chest percussion
• inhaled bronchodilators

Question 9

bronchiectasis: surgical ttt

Answer 9

surgical resection reserved for the few patients with localized bronchiectasis and adequate pulmonary function who fail to conservative management

Question 10

bronchiectasis: complications

Answer 10

cor pulmonale, amyloidosis and secondary visceral abscesses at distant sites ex: brain