Bronchiectasis Flashcards
What is bronchiectasis?
irreversibly damaged bronchi
dilated and thickened
colonised with bacteria that lead to pus formation and mucus hypersecretion
What are the main organisms bronchiectasis patients are infected with?
Haemophilus Influenzae
Pseudomonas Aeruginosa
Streptococcus Pneumoniae
Staphylococcus Aureus
Bronchiectasis causes
Post-infection - TB, HIV, measles, Pertussis, Pneumonia
Bronchial pathology - obstruction by foreign body/tumour
Allergic Bronchopulmonary Aspergillosis (ABPA)
Congenital - CF, Kartagener’s syndrome, primary ciliary dyskinesia, Young syndrome
Hypogammaglobulinaemia
Idiopathic
Connective tissue diseases - RA, systemic sclerosis
Kartagener’s syndrome genetics
autosomal recessive genetic ciliary disorder`
Kartagener’s syndrome triad
situs inversus
chronic sinusitis
bronchiectasis
Bronchiectasis symptoms
productive cough
large amounts of purulent sputum
haemoptysis
Bronchiectasis signs
finger clubbing
coarse inspiratory crepitations
dyspnoea
wheeze
What is a pack year?
20 cigarettes/day for one year = 1 pack year
What is normal internal organ arrangement called?
situs solitus
Who does ABPA occur in?
asthmatics
patients with CF
What scan is used to diagnose bronchiectasis?
HRCT (high resolution computerised tomography)
- tram-line sign = dilated airways in horizontal direction
- signet ring = dilated airways adjacent to pulmonary artery branch give ring appearance
Conservative management of bronchiestasis
patient education
smoking cessation
support group
chest physiotherapy - postural drainage 2x/day to aid mucus drainage
Medical management of bronchiectasis
antibiotics - can have longer-term/prophylactic Abx if exacerbations recurrent
bronchodilators - Including salbutamol can be given to patients with symptoms of dyspneoa and wheeze such as COPD, ABPA, asthma
Corticosteroid - Prednisolone is used in ABPA treatment
Carbocysteine - Mucolytic which reduces the viscosity of sputum
Surgical management of bronchiectasis
Surgical excision of localized area of disease or cessation of haemoptysis
Lung transplant may be indicated in certain patients
Where in the lungs is most affected in bronchiectasis?
middle + lower lobes
