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RESP > Bronchiectasis > Flashcards

Bronchiectasis Flashcards

1
Q

What are the 3 risk factors for developing chronic pulmonary infection?

A
  1. Abnormal host response- immunodeficiency, immunosuppression (drugs, cancer)
  2. Abnormal innate host defence- damaged bronchial mucosa, cilia
  3. Repeated insult- aspiration, indwelling material.
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2
Q

What are some common causes of immunodeficiency? (4)

A
  1. Immunoglobin deficiency
  2. Hypo-splenism- loss of B lymphocytes through non functioning spleen
  3. HIV
  4. Immune paresis- (myeloma, lymphoma)
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3
Q

What are the common types of Immunoglobin deficiency? (3)

A
  1. IgA deficiency
  2. Hypoglobulinanaemia
  3. CVID
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4
Q

What are some causes of damaged bronchial mucosa? (3)

A
  1. Smoking
  2. Malignancy
  3. Infection (pneumonia or flu)
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5
Q

What are some reasons of abnormal cilia production?

A
  1. Kartengers

2. Youngs

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6
Q

Some causes of abnormal mucus? (2)

A
  1. CF

2. Channelopathies- disturbance in ion channel and its functioning

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7
Q

Some forms of CHRONIC pulmonary infection. (dont need to remember this)

A
  1. Intrapulmonary abscess
  2. Empyema
  3. Chronic bronchial sepsis
  4. Bronchiectasis
  5. CF & other oddities
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8
Q

What are the common symptoms of intrapulmonary abscess? (3)

A
  1. Weight loss
  2. Cough +/- sputum
  3. Tiredness

Intrapulmonary Abscess- Severe localised lung infection associated with necrotic cavity formation.

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9
Q

What kind of things can an intrapulmonary abscess be proceeded by?

A
  1. Pneumonia
  2. Foreign body
  3. Post viral
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10
Q

Some common bacterial and fungal pathogens that can cause intrapulmonary abscess?

A

Bac

  1. Strep
  2. Staph
  3. E. coli
  4. Gram -

Fungal - Aspergillus

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11
Q

Apart from right sided endocarditis, a septic emboli can also cause _ and _ .

A
  1. Infected DVT

2. Septicaemia

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12
Q

Empyema is the formation of _ in the _

A

pus, pleural space

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13
Q

What is the commonest cause of Empyema?

A

Pneumonia, rest are idiopathic, iatrogenic (due to treatment)

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14
Q

Changes in what factors marks progression from simple to complicated effusion to empyema?

A
  1. pH- More than 7.2 in simple but keeps decreasing till empyema
  2. LDH- initially less than a 1000 but increases to a 1000 in empyema.
  3. Glucose- Initially more than 2.2, decreases less to it.
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15
Q

Complicated parapneumonic effusion requires a chest tube drainage. T/F?

A

True

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16
Q

Aerobic Gram + and - such as what usually cause empyema?

A

Gram +

  1. Strep mileri
  2. Staph aureus

Gram -

  1. E. coli
  2. H. influenzae
  3. Klebsiella
  4. Pseudomonas
17
Q

What factors can determine empyema diagnosis?

A
  1. Slow resolving Pneumonia
  2. Persisting Locular (cavity) effusion
  3. CT.

USS- Ultrasound most definite way to confirm diagnosis

18
Q

Pleural effusions often show up on CXR’s as a _ shaped sign.

A

D- lungs reduced to that shape.

19
Q

Treatment for Empyema? (2)

A
  1. Chest drainage- 5 intercostal space? removes fluid
  2. Antibiotics
    IV- broad spectrum: amoxicillin
    Oral- targeted to pathogen
20
Q

Bronchiectasis is the localised, irreversible _ of the bronchial tree.

A

Dilation

21
Q

Involved bronchi are dilated, _ and easily collapsible.

A

Inflammed

22
Q

Bronchiectasis does not affect clearance of secretions. T/F?

A

False- impaired secretion clearance

23
Q

What are the symptoms and signs of Bronchiectasis? (3 each)

A

Symptoms

  1. Recurrent infections
  2. Copious purulent sputum.
  3. +/- haemoptysis

Signs

  1. Finger clubbing
  2. Coarse inspiratory crackles (NB- Fine crackles seen in pulmonary fibrosis)
  3. Wheeze
24
Q

Common pathogens causing Bronchiectasis? (4)

A
  1. H influenzae
  2. Strep pneumonia
  3. Staph aureus
  4. Pseudomonas
25
Q

Bronchiectasis usually causes lower respiratory tract infections. T/F?

A

True

26
Q

Some common causes of Bronchiectasis?

A
  1. Congenital- CF, Youngs, Kartanagers

2. Others- bronchial obstruction, Rheumatoid, hypogammaglobulinaemia,

27
Q

More than 50% of Bronchiectasis cases are idiopathic. T/F?

A

True

28
Q

Chronic bronchial sepsis has the same hallmarks as bronchiectasis but different CT appereances. T/F?

A

True

29
Q

Chronic bronchial sepsis usually affects _ people

A

Young.

Older - associated with COPD or other airway disease

30
Q

What is the treatment for Bronchiectasis when colonised by bacteria?

A
  1. Prophylactic- Nebulised gentamicin, colomycin
  2. Macrolides- Clarithromycin, Azithromycin 250mg
    Anti-inflammatory antibiotics reduce exacerbation rates in bronchiectasis.

RESP (25 decks)

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