Bronchiectasis Flashcards
What is bronchiectasis?
Abnormal chronic dilation and distortion of one or more bronchi due to extensive inflammation and destruction of the bronchial wall cartilage.
What are examples of acquired bronchiectasis?
Pulmonary infections, bronchial obstruction, pulmonary TB, foreign body aspiration.
What are some examples of congenital bronchiectasis?
Kartagener’s syndrome, Hypogammaglobulinemia, Cystic Fibrosis
What is Kartagener’s syndrome?
An autosomal recessive genetic ciliary disorder which causes defective movement of the cilia, leading to recurrent chest infections. It causes triad of situs inversus, chronic sinusitis, and bronchiectasis.
What is hypogammaglobulinemia
Variable immunodeficiency (IgE deficiency leading to frequent infection).
How does bronchiectasis affect the lungs?
Bronchial wall destruction, mucociliary clearing mechanism impaired, copious foul smelling secretions, bronchial smooth muscle constriction, bronchi and bronchioles distal to affected area become partially or totally obstructed.
Is bronchiectasis obstructive or restrictive?
Both
What kind of damage does bronchiectasis lead to?
Hyperinflation of distal alveoli, atelectasis, consolidation, parenchymal fibrosis, reduced lung volumes, and scarring.
What are the three types of bronchiectasis?
Varicose (fusiform), cylindrical, and saccular (cystic)
What is varicose bronchiectasis?
Bronchi are dilated and constricted in an irregular fashion.
What is cylindrical bronchiectasis?
Bronchi are dilated and have regular outlines (look like tubes). It is the least severe form as the bronchiectatic areas drain well.
What is saccular bronchiectasis?
The formation of large sacs which causes complete destruction of the bronchial walls which become fibrotic.
What lab findings might you expect in bronchiectasis?
Sputum culture containing haemophilus influenzae, streptococcus, or pseudomonas aeruginosa.
How do we diagnose bronchiectasis?
Bronchoscopy, CXR, and CT (best diagnostic tool)
What is notable about a sputum sample from a patient with bronchiectasis?
The sputum will separate into three layers; a thin frothy layer on top, a mucopurulent layer in the middle, and an opaque mucopurulent to purulent layer with mucus plugs, pus, and cell debris.
