Bronchiectasis Flashcards
Bronchiectasis
Chronic lung disease of bronchi and
bronchioles
Pathophysio of bronchiectasis
1.progressive, irreversible and persistent
inflammation, dilatation
2. impaired mucus clearance
3. bacterial colonization
4.Destruction of smooth muscle, elastic
tissue and cartilage in bronchial walls
main two types of bronchiectasis
Focal and diffuse
localized bronchiectasis MC ways
Impaired local mucous drainage and
infection due to obstruction
o Aspirated foreign body
o Benign endobronchial tumour
o External compression (enlarged lymph
node)
other causes of focal bronchiectasis
TB
following severe pneumonia
allergic bronchopulmonary aspergillosis
Diffuse bronchiectasis main two causes
Post infectious
Altered host defenses
Post infectious diffuse bronchiectasis causes
Tuberculosis
Nontuberculous mycobacteria(MAC)
Recurrent childhood lung infections
Altered host defenses diffuse bronchiectasis
Impaired mucociliary clearance (Cystic
fibrosis, Kartagener syndrome)
Immunoglobulin deficiency
Alpha 1 antitrypsin deficiency
clinical features of bronchiectasis
Persistent cough and sputum
Thick, purulent, blood streaked sputum
Frank haemoptysis
Dyspnoea
Malaise, weight loss, fever
Clubbing
Coarse crackles, rhonchi
May not have any symptoms at all
Dx bronchiectasis
CXR
HRCT
CBC
Sputum microbiological test
Spirometry
X-ray sinuses
Alpha 1 anti-trypisin levels
CF genetic studies
skin testing for aspergillus
CXR findings in bronchiectasis
normal in 50% patients
ring shadows, tram tracks and rail roads
most sensitive test for bronchiectasis
HRCT
Treatment of bronchiectasis
Bronchial hygiene
mucolytics
avoid infections
antibiotics
bronchodilators
surgery
bronchial hygiene in bronchiectasis
hydration
nebulized saline
active cycle breathing techniques
mechanical devices for sputum clearance
postural drainage
the mucolytic agent used in bronchiectasis
nebulized acetylcysteine
