Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Kendigs Respiratory Diseases > Bronchiectasis > Flashcards

Bronchiectasis Flashcards

1
Q

What are the three conditions that share common features but are different diagnostic entities?

A

Bronchiectasis, Chronic Suppurative Lung Disease (CSLD), Protracted Bacterial Bronchitis (PBB)

These conditions have overlaps in symptoms and features.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Protracted Bacterial Bronchitis (PBB)?

A

A condition that is likely a prebronchiectasis state.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define Chronic Suppurative Lung Disease (CSLD).

A

A clinical syndrome where symptoms of chronic endobronchial suppuration exist without c-HRCT evidence of bronchiectasis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Bronchiectasis?

A

A pathologic state of the conducting airways manifested by radiographic evidence of bronchial dilation and chronic productive cough.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the clinical manifestations of Bronchiectasis?

A
  • Chronic productive cough
  • Focal recurrent wet cough
  • Infectious exacerbations
  • Diffuse airway obstruction
  • Respiratory failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the diagnostic criteria for bronchiectasis based on?

A

Radiographic features of chest high-resolution computed tomography (c-HRCT).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a key sign of bronchiectasis regarding the bronchoarterial ratio?

A

Increased bronchoarterial ratio of > 1 to 1.5.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the normal bronchoarterial ratio in young children aged <5 years?

A

0.5.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List some etiologic risk factors for Bronchiectasis.

A
  • Structural airway abnormalities
  • Persistent airway injury
  • Recurrent airway injury
  • Impaired upper airway defenses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are common causes of previous Acute Lower Respiratory Infections (ALRIs) that can lead to bronchiectasis?

A
  • Tuberculosis
  • Pertussis
  • Adenovirus
  • Measles
  • Severe viral pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are Reid’s subtypes of bronchographic findings?

A
  • Cylindrical
  • Varicose
  • Cystic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the macroscopic features of bronchiectasis?

A

Airways are tortuous and dilated, sometimes extending to the pleural surface.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are early histologic changes observed in bronchiectasis?

A
  • Bronchial wall thickening
  • Edema
  • Presence of inflammatory cells
  • Development of lymphoid nodules
  • Mucus gland hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the presenting clinical features of bronchiectasis?

A
  • Chronic productive cough
  • Recurrent wheezing
  • Chest infections
  • Hemoptysis
  • Growth failure
  • Clubbing
  • Hyperinflation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the gold standard for diagnosing bronchiectasis?

A

Chest high-resolution computed tomography (HRCT).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a characteristic radiographic finding in bronchiectasis?

A

Signet ring appearance where a dilated bronchus is greater than the diameter of the accompanying blood vessel.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are common respiratory pathogens in children with bronchiectasis?

A
  • Streptococcus pneumoniae
  • H. influenzae nontype b
  • Moraxella catarrhalis
  • Pseudomonas aeruginosa (in severe cases)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the major criteria for assessing exacerbation in bronchiectasis?

A
  • Presence of a wet cough
  • Cough severity score of ≥2 over 72 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the recommended management for bronchiectasis secondary to CF and PCD?

A
  • Aggressive management of infections
  • Regular use of airway clearance methods
  • Attention to nutrition
  • Vigilant monitoring of long-term clinical trends
20
Q

What effect do macrolides have in the management of bronchiectasis?

A

Significantly reduced exacerbations compared to placebo.

21
Q

What is the prognosis for bronchiectasis?

A

Varied, from mild respiratory morbidity to death.

22
Q

What are the unfavorable prognostic factors for patients with bronchiectasis?

A
  • Presence of asthma
  • Bilateral lung involvement
  • Saccular bronchiectasis
  • Frequency of exacerbations
  • Presence of P. aeruginosa
23
Q

What is the prevalence range of Protracted Bacterial Bronchitis (PBB) reported in studies?

A

6% to 42%.

24
Q

What microbiological findings are common in Protracted Bacterial Bronchitis?

A
  • S. pneumoniae
  • H. influenza
  • M. catarrhalis
  • Adenovirus
25
What features characterize the immune response in Protracted Bacterial Bronchitis?
* Absence of systemic immunodeficiency * Robust vaccine responses * Upregulated innate immunity
26
What is the first feature of Protracted Bacterial Bronchitis (PBB)?
Absence of an overt systemic immunodeficiency (normal serum IgA, IgM, IgG, and IgE levels) ## Footnote This indicates that PBB does not involve a general immune deficiency.
27
What type of vaccine responses are observed in PBB?
Robust responses to protein (tetanus) and conjugated protein-polysaccharide (H. influenzae type b) vaccines ## Footnote This reflects the intact functionality of the adaptive immune system in PBB.
28
Which innate immunity markers are upregulated in PBB?
Elevated TLR-2, TLR-4, human β-defensin 2 (hBD2), and mannose-binding lectin (MBL) ## Footnote These markers are indicative of an enhanced innate immune response.
29
What is a key characteristic of Bronchoalveolar Lavage (BAL) in PBB?
Intense airway neutrophilia ## Footnote This indicates a strong inflammatory response within the airways.
30
What pro-inflammatory mediators are increased in BAL for PBB?
Increased IL-8, MMP-9, and IL-1β ## Footnote These mediators play a significant role in inflammation and airway remodeling.
31
What is the main pathway activated in PBB?
Increased IL-1β pathway activation ## Footnote This pathway is crucial for mediating inflammatory responses.
32
What is commonly found in children with PBB?
Tracheobronchomalacia (TBM) ## Footnote TBM can contribute to chronic cough due to airway obstruction.
33
What typically resolves the chronic ineffective cough in PBB?
Treatment of the underlying infection ## Footnote This suggests that the cough is secondary to the infection rather than a primary issue.
34
What predisposes a child to PBB?
Primary airway malacia ## Footnote This condition reduces the efficiency of airway clearance, leading to bacterial colonization.
35
What are the clinical features of PBB?
Typically appears well, absence of recurrent nasal or ear disease, normal growth and development ## Footnote These features suggest a localized rather than systemic issue.
36
What imaging findings are typical for PBB?
Normal or near-normal CXR with peribronchial changes ## Footnote This indicates that while structural changes may be present, they are not always apparent on imaging.
37
What are the lab findings in PBB?
Absence of serum neutrophilia or systemic inflammation ## Footnote This helps differentiate PBB from systemic infections.
38
What are the diagnostic criteria for Protracted Bacterial Bronchitis?
1. History of chronic wet cough 2. Positive BAL cultures for respiratory bacterial pathogens at densities ≥104 cfu/mL without evidence of Bordatella pertussis or Mycoplasma pneumoniae 3. Cough resolution after a 2-week course of oral antibiotics (amoxicillin-clavulanate) ## Footnote These criteria help confirm the diagnosis of PBB.
39
How does acute bronchitis differ from PBB?
Acute bronchitis cough usually resolves within 2 to 4 weeks ## Footnote This is a key differentiator in the clinical presentation.
40
What does bronchitis refer to?
Inflammation of the bronchus or bronchi ## Footnote Bronchitis can have various causes and presentations based on inflammation type and duration.
41
What type of inflammation is seen in acute viral bronchitis?
Both lymphocytic and neutrophilic inflammation ## Footnote This reflects the immune response to viral infections.
42
What does chronic (>4 weeks) wet cough in children signify?
Persistence of increased airway secretion production or decreased airway clearance in the large airways ## Footnote This indicates ongoing issues with airway management.
43
What is the typical management approach for PBB?
Child's cough resolves only after a 2-week course of appropriate antibiotics ## Footnote This emphasizes the importance of targeted antibiotic therapy.
44
What does BTS suggest for the duration of antibiotic treatment in PBB?
4 to 6 weeks of antibiotics ## Footnote This recommendation may vary based on clinical response.
45
What is Kendig's initial recommendation for antibiotic treatment duration?
2-week course initially ## Footnote This reflects a more conservative approach to treatment.

Kendigs Respiratory Diseases (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions