Bronchiectasis Flashcards
What is bronchiectasis?
Uncommon chronic lung condition, characterised by irreversibly dilated bronchi with chronic bronchial inflammation and infection
Bronchiectasis can lead to significant respiratory complications if not managed properly.
What are the common causes of bronchiectasis?
- Idiopathic
- Post-infection (commonly pneumonia)
- Immunodeficiency
- COPD
- Cystic Fibrosis
- Kartagener’s syndrome
Cystic Fibrosis associated bronchiectasis is treated as a distinct entity and requires investigation if suspected.
What are the symptoms of bronchiectasis?
- Chronic productive cough
- **Daily sputum **production (clear or green)
- Haemoptysis
- Recurrent chest infection
- Rhinosinusitis
- Dyspnoea
- Chest pain
- GORD (common comorbidity)
Patients are often female and non-smokers.
What signs are associated with bronchiectasis?
- Crackles
- Wheeze
- Clubbing
These signs can be indicative of underlying lung pathology.
What are some co-morbidities associated with bronchiectasis?
- Rheumatoid arthritis (RA)
- Inflammatory bowel disease (IBD)
- Cystic Fibrosis (malabsorption + pancreatitis)
- GORD
Investigate these conditions if the patient is not already diagnosed.
What are the key investigations for bronchiectasis?
- Sputum cultures (commonly Haemophilus influenzae and Pseudomonas aeruginosa)
- FBC
- Serum total IgE
- CXR
- Post-bronchodilator spirometry
- CT scan
CT scan findings may include signet ring sign, lack of bronchial tapering, tram tracks, and bronchus visible within 1 cm of pleura.
++++ CT findings for Bronchiectasis
CT scan findings may include:
- signet ring sign
- Lack of bronchial tapering
- Tram tracks
- Bronchus visible within 1 cm of pleura.
- Thickening of bronchial walls
What pathogen is commonly associated with bronchiectasis (foun in sputum/cause of disease)?
Haemophilus influenzae and Pseudomonas aeruginosa
What is the management for stable bronchiectasis?
** PHYSIO: **Airway clearance techniques (e.g. ACBT)
* Annual influenza vaccine
* Antibiotics for exacerbations
* Self-management plan
Physiotherapist care is important for improving mucus clearance and cough efficiency.
What is the management for infective exacerbations of bronchiectasis?
- Antibiotics (long-term rotating antibiotics for severe cases)
- SABA inhaler if SOB
Prompt treatment of exacerbations is crucial to prevent further lung damage.
What is allergic bronchopulmonary aspergillosis?
Common in history of bronchiectasis and eosinophilia, caused by Aspergillus spores.
ABPA is an allergic reaction to Aspergillus fungi, most commonly Aspergillus fumigatus, that colonizes the airways of individuals with asthma or cystic fibrosis
It requires specific investigations and management.
What investigations are needed for allergic bronchopulmonary aspergillosis?
- Eosinophilia
- CXR changes
- RAST test (aspergillus)
- IgG and raised IgE
These tests help confirm the diagnosis and guide treatment.
What is the management for allergic bronchopulmonary aspergillosis?
Oral glucocorticoids (e.g. Prednisolone)
Effective management can lead to significant improvement in symptoms.
