Bronchiectasis Flashcards
What is bronchiectasis?
Permenant dilation of the bronchi
What are the causes of bronchiectasis?
Idiopathic - most common
Pneumonia
Whooping cough
TB
Alpha-1-antitrypsin deficiency
Connective tissue disorders
Cystic fibrosis
What are the risk factors for bronchiectasis?
Increasing age
Smoking
Female sex
What is yellow nail syndrome?
A triad of yellow nails, bronchiectasis and lymphoedema
What is the clinical presentation of bronchiectasis?
Shortness of breath
Excess sputum production
Haemoptysis
Weight loss
Recurrent chest infection
Chronic productive cough
What are the signs of bronchiectasis on examination?
Weight loss
Finger clubbing
Raised JVP
Peripheral oedema
Coarse crackles during inspiration
Scattered wheezes and squeaks
What is the definitive investigation for diagnosis of bronchiectasis?
High resolution CT chest
- Bronchial dilation and bronchial wall thickening
What other investigations are used in the diagnosis of bronchiectasis?
CXR - diated airways with thickened walls
Sputum cultures - identifying colonising pathogens
FBC - assess for infection
What are the most common infective organisms in bronchiectasis?
Haemophilus influenza
Pseudomonas aeruginosa
What is the management of bronchiectasis?
First line
- Chest physiotherapy
- Annual influenza vaccine
- Antibiotics for acute exacerbations
Second line
- Mucoactive agent - carbocisteine
- Bronchodilator
- Long term antibiotics - macrolide for three or more exacerbations a year
What are the complications of bronchiectasis?
Infective exacerbations
Bacterial colonisation
Pneumothorax
Respiratory failure
Cor pulmonale
What is the management of an infective exacerbation?
Sputum culture (before antibiotics)
Extended course of antibiotics - 7-14 days
- Ciprofloxacin for pseudomonas
