Bronchiectasis Flashcards
What is bronchiectasis?
Abnormal and permanently dilated airways. Bronchial walls become inflamed, thickened and irreversibly damaged. The mucociliary transport mechanism is impaired and frequent bacterial infections ensue. Clinically, the disease is characterized by productive cough with large amounts of discoloured sputum, and dilated, thickened bronchi, detected on CT.
What are Congenital causes of bronchiectasis?
- CF
- Primary ciliary dyskinesia
- Young’s syndrome
- Kartagener’s syndrome
What are infective causes of bronchiectasis?
- Measles
- Pertussis
- Bronchiolitis
- Pneumonia
- TB
- HIV
What are other causes of bronchiectasis besides congenital and post infective causes?
- Bronchial obstruction
- Allergic bronchopulmonary aspergillosis
- Hypergammaglobulinaemia
- RA
- UC
- Idiopathic
What are symptoms of bronchiectasis?
- Persistent cough
- Copious purulent sputum
- Intermittent haemoptysis
What are signs of bronchiectasis?
- Finger clubbing
- Coarse inspiratory crepitations
- Wheeze - COPD, asthma, ABPA
What complications are associated with bronchiectasis?
- Penumonia
- Pleural effusions
- Pneumothorax
- Haemoptysis
- Cerebral abscess
- Amyloidosis
What tests would you do if you suspected that someone had bronchiectasis?
- Sputum culture
- CXR
- HRCT chest
- Spirometry
- Bronchoscopy
- Look for casuses - CF sweat test, Aspergillus precipitins, skin prick
What might you see on CXR in someone with bronchiectasis?
- Cystic shadows
- Thickened bronchial walls
What features might you see on Spirometry in someone with bronchiectasis?
Obstructive pattern - test reversibility
What might you find on bronchoscopy?
- Source of haemoptysis
- Exclude obstruction
- Obtain samples
How would you manage someone with bronchiectasis?
- Postural drainage - twice daily
- Chest phsyio
- Antibiotics
- Bronchodilators - Asthma, COPD, ABPA
- Cotricosteroids
- Surgery - control haemoptysis, in localised disease
