Bronchiectasis Flashcards
what is it?
chronic infection of the bronchi and bronchioles leading to permanent dilatation of the airways , resulting inflammation and thickening of the walls
what leads to recurrent bacterial infections ?
the mucociliary transport mechanism is impaired so cannot remove foreign pathogens
what do people with bronchiectasis normally present like?
recurrent chest infections
recurrent antibiotic prescriptions
no response to antibiotics
persistent sputum production
what are the congenital causes of bronchiectasis ?
CF
young’s syndrome
primary ciliary dyskinesia
Kartagener’s syndrome
what are the post infection causes of bronchiectasis ?
measles, pertussis, bronchiolitis, pneumonia, TB, HIV
what are the other causes of bronchiectasis ?
bronchial obstruction (tumour foreign body) allergic bronchopulmonary aspergillosis hypogammaglobulinaemia, rheumatoid arthritis, ulcerative colitis, idiopathic
what are the symptoms?
productive cough (yellow green sputum, can become haemoptysis)
as the condition progresses get Halitosis (bad breath)
recurrent febrile episodes, malaise
what are the signs ?
finger clubbing
coarse inspiratory crepitation,
wheeze (asthma, COPD, ABPA)
which organisms infect those with bornchiectasis ?
main ones are H. influenzae; Strep. pneumoniae; Staph. aureus; Pseudomonas aeruginosa.
what are the complications of bronchiectasis?
pneumonia, pleural effusion, pneumothorax, haemoptysis, cerebral abscess, amyloidosis
empyema
what does the life threatening haemoptysis complication originate from?
the high pressure systemic bronchial arteries
what are the investigations?
sputum culture
CXR
CT
sinus X rays
spirometry
bronchoscopy
other tests
sweat electrolytes - if CF suspected
mucociliary clearance
IgA deficiency
what would the CXR show?
cyctic shadows, thicked bronchial walls
sometimes multiple cysts conatining fluid
bronchi are bigger than their accompanying pulmonary artery: this is the signet ring appearance
why is a CT done?
to assess the extent and distribution of the disease
what is shown from spirometry ?
shows an obstructive pattern, reversibility should be assessed
