BRONCHIECTASIS

Question 1

• Abnormal, permanent dilatation of bronchi

* Caused by inflammation and destruction of the structural components of the bronchial wall

Answer 1

BRONCHIECTASIS

Question 2

Bronchi appear as uniformly dilated tubes that end abruptly at the point where smaller airways are obstructed by secretions.

Answer 2

CYLINDRICAL BRONCHIECTASIS

Question 3

Affected bronchi have an irregular or beaded pattern of dilatation resembling varicose veins.

Answer 3

VARICOSE BRONCHIECTASIS

Question 4

Bronchi have a ballooned appearance at the periphery,

ending in blind sacs without recognizable bronchial structures distal to the sacs

Answer 4

SACCULAR (CYSTIC) BRONCHIECTASIS

Question 5

SIGNS & SYMPTOMS OF BRONCHIECTASIS

Answer 5

• Patients typically present with:
• Persistent or recurrent cough
• Purulent sputum production
• Tracheobronchial secretions are typically copious and thick and contribute to symptoms.
• Often associated with “dry” bronchiectasis in an upper lobe
• Hemoptysis
• Dyspnea or wheezing

Question 6

PHYSICAL EXAMINATION OF BRONCHIECTASIS?

Answer 6

• Tachypnea
• Hypoxemia
• Any combination of crackles, rhonchi, and wheezes Reflects damaged airways containing significant secretions
• Clubbing of the digits
• Signs of cor pulmonale and right ventricular failure In patients with severe, diffuse disease, particularly those with chronic hypoxemia

Question 7

Standard technique for detecting or confirming the diagnosis of bronchiectasis

Answer 7

Chest CT or highresolution CT

Question 8

Saccular bronchiectasis may show what in chest radiography.

Answer 8

“Tram tracks” and “ring shadows”

Question 9

TREATMENT APPROACH (4 MAJOR GOALS) OF bronchiectasis

Answer 9

1. Treatment of infection, particularly during acute exacerbations
2. Improved clearance of tracheobronchial secretions
3. Reduction of inflammation
4. Treatment of an identifiable underlying problem

Question 10

Particularly useful in patients with airway hyperreactivity and reversible airflow obstruction in bronchiectasis

Answer 10

Bronchodilators

Question 11

Consider removal of areas of diseased lung when: Bronchiectasis is localized

Answer 11

Surgery Indicated for removal of foreign body or obstructing tumor

Question 12

MANAGEMENT OF SECRETIONS OF BRONCHIECTASIS

Answer 12

• Adequate hydration and use of nebulized saline can help thin secretions.
• Antibiotics For patients with acute exacerbations
• empiric choice should cover H. influenzae & S. aureus.

Question 13

COMPLICATIONS OF BRONCHIECTASIS

Answer 13

• Recurrent infections
• Disabling cough
• Massive hemoptysis
• Chronic hypoxemia
• Cor pulmonale
• Death