Bronchiectasis Flashcards
What is Bronchiectasis
Uncommon disease due to infection causing permanent dilation of conduction airways
What is bronchiectasis categorized as
COPD due to airway collapse, leading to obstruction
What can cause Bronchiectasis
CF A1A deficiency Aspiration Autoimmune disease primary infection
What are the causative agents of Bronchiectasis
**H. Influenza (non-CF patients)
Pseudomonas (accelerated, more frequent, rapid lung decline)
Staph aureus, Strep pneumo
What happens pathologically in Bronchiectasis
Abnormal dilation of proximal bronchioles (>2mm)
Muscular and elastic component of bronchial wall is destroyed due to inflammation
Mucus with pathogens gets trapped and can’t be coughed up= copies mucopurulent sputum
What are symptoms of bronchiectasis
Cough w/ sputum (mucopurulent) lasta Mo-Yrs
blood streaked hemoptysis (airway damage)
Pleuritic CP
dyspnea, wheezing, weight loss, fever, clubbing
What findings are rare to see in bronchiectasis
cyanosis and wasting
What are differentials to consider
COPD Asthma Pneumonia A1A deficiency CF GERD
What is gold standard imaging diagnostic test for Bronchiectasis
High Resolution CT (HRCT)
What other diagnostic tests are available
sputum analysis
Gram stain/culture (Pseudomonas or E. Coli)
CXR (normal or abn)
What is a Dittrich plug
white/yellow concentration found on sputum analysis
What are common findings on CXR if it is abnormal
ring structure
atelectasis
mucus plugs
“tram lines” (thick dilated airways)
What labs diagnose Bronchiectasis
CBC (left shift, polycythemia)
Serum A1A
Sweat test to r/o CF
Autoimmune screening
Why does polycythemia develop in hypoxia
the body tries to compensate for low oxygen by up regulating RBC, which normally carry oxygen
What does an Obstructive spirometry look like
FVC: normal (or low)
FEV: Low
FEV1/FVC: Low
(TLC is high)
