Bronchiectasis

Question 1

What is bronchiectasis

Answer 1

• repeated infection in the airways resulting in damage and dilation of airways
• due to accumulation of pus in dilated bronchi
• due to inflammatory changes in lung and pleura surrounding dilated bronchi

Question 2

MCC of bronchiectasis

Answer 2

TB

Question 3

main physical sign of bronchiectasis

Answer 3

coarse crackles, clubbing

Question 4

gold standard of confirmation

Answer 4

CT

Question 5

mild sputum production
moderate
severe

Answer 5

<15 cc
15-150 cc
>150 cc

Question 6

diagnostic evaluation

Answer 6

first do a sputum culture, check IG level, check AAT deficiency

Question 7

first line Abx tx

Answer 7

amox, clarithromycin in PCN allergic

cipro for psuedomonas plus another abx like colistin or gentamycin (requires long term)

Question 8

mucolytic agents

Answer 8

nebulize hypertonic saline or mannitol

Question 9

PEP device

Answer 9

positive expiratory pressure

Question 10

do bronchodilators/ICS work?

Answer 10

not really, main thing is to suppress bacterial growth

Question 11

cystic fibrosis

Answer 11

cystic fibrosis transmembrnae conductance regulator (CFTR) affected

• results in defective production of CFTR leading to faulty transport of salt
• mucus dries out
• bilateral polyps

Question 12

how to dx CF?

Answer 12

sweat chloride test >70mEq

Question 13

pts with CF are nutrient deficient for

Answer 13

• lipase/amylase

- fat soluble vitamins (A/K/E/D)

Question 14

bronchiectasis presents w/

Answer 14

• cough
• increased sputum
• massive hemoptysis
• crackles