Bronchiectasis Flashcards
What type of disease is Bronchiectasis?
Obstructive lung disease
What does bronchiectasis result in?
Local irreversible dilation of the bronchial tree.
What is bronchiectasis due to?
Destruction of muscle and elastic tissue
What is bronchiectasis usually a result of?
Bronchial obstruction leading to infection with inflammation
What is the most common cause of bronchiectasis in the UK?
Cystic fibrosis
What is the most common cause of bronchiectasis worldwide?
TB
What are the main symptoms of Bronchiectasis?
Persistent cough
Copious purulent sputum
Intermittent haemoptysis
What are the main signs of bronchiectasis?
Finger clubbing
Coarse inspiratory crepitations
Wheeze
What chest sounds would be present with bronchiectasis?
Coarse crackles
wheeze
What organisms commonly cause bronchiectasis?
- Haemophilius Influenzae
- Pseudomonas aeruginosa
- Streptococcus Pneumoniae
- Staphylococcus aureus
What is the most common organism that can be isolated from patients with bronchiectasis?
Haemophilus influenza
What are other common causes of Bronchiectasis?
- bronchial obstruction e.g. lung cancer/foreign body
- immune deficiency: hypogammaglobulinaemia
- allergic bronchopulmonary aspergillosis (ABPA)
- ciliary dyskinetic syndromes: Kartagener’s syndrome
What immune deficiency can predispose to bronchiectasis?
Hypogammaglobulinemia
What ciliary dyskinetic syndrome can predispose to bronchiectasis?
Kartagener’s syndrome
Young’s syndrome)
What are the main 3 tests for someone presenting with possible bronchiectasis?
Sputum sample
Chest x-ray
CT chest
Why might you do a sputum sample for someone presenting with possible bronchiectasis?
To identify pathogens and guide management with antibiotics.
What is the problem with doing a chest x-ray in someone with broncheictasis?
This will be normal, unless the bronchiectasis is widespread/advanced
What is the best diagnostic test for bronchiectasis?
CT chest
What might you see on a chest x-ray in someone with advanced bronchiectasis?
Areas of thickened bronchial walls and Cystic appearance
(Tramline and ring shadows)
What might you see on a CT of someone with bronchiectasis?
Bronchial dilatation
Bronchial wall thickening
Classic signet ring appearance
What is the main management for patients that do not have CF?
Physical training (e.g. inspiratory muscle training
What else can be done for patients with broncheictasis?
postural drainage
antibiotics for exacerbations
bronchodilators i
immunisations
surgery- Localised disease
When might you consider surgery in a patient with bronchiectasis?
If the disease is localised
What are possible complications of bronchiectasis?
Abscess
Empyema
Pulmonary fibrosis
Cor pulmonale
Secondary Amyloidosis
What are the conservative managements of bronchiectasis?
Patient Education
Support Group
Chest Physiotherapy
Smoking Cessation
What does chest phsyiotherapy involve?
Postural drainage at least twice daily to aid mucous drainage
What can be used to reduce the viscosity of the sputum?
Mucolytics- Carbocysteine
Example of patient
2-year history of cough productive with copious thick yellow sputum and SOB on exertion.
Cough has been intractable
Given multiple courses of antibiotics with no success.
On examination, low-pitched expiratory wheezes and crackles in both lungs and fingernail clubbing is noted. A chest x-ray shows airway thickening.
