Bronchiectasis Flashcards
What is bronchiectasis?
Chronic dilatation of one or more bronchi
Poor mucous clearance
Predisposition to bacterial infection
What are the 3 possible types of dilation in bronchiectasis?
Cylindrical - dilated in a straight line
Varicose - twisted like varicose veins
Cystic - round and circular like cysts
What would a CT scan show?
Dilated airways
Signet ring sign
Bronchus that is bigger than artery
In how many cases is the aetiology known? (how its happened)
40%
What are the 6 main broad aetiologies of bronchiectasis? Give some examples of each
Post infection - measles whooping cough childhood pneumonia TB
Immune deficiency -
HIV
Lung transplant
Allergic bronchopulmonary aspergillosis (ABPA)
Defective clearance -
Primary ciliary dyskinesia (Kartagener’s)
Cystic fibrosis
Toxic -
Aspiration
Mechanical -
Tumour
Lumphnode
Foreign body
Other (just for interest) - Rheumatoid IBD Coeliac's Alpha 1 antritrypsin deficiency
What is Allergic bronchopulmonary aspergillosis? (ABPA)
infection caused by a particular fungus -airborne spores that get into the lungs - cause a particular pattern of bronchiectasis
What are the most common aetiologies causing bronchiectasis?
or the ones you defo need to know) (7
Previous measles Previous pneumonia Immunodeficiency TB Connective tissue disorder Foreign body Alpha 1 antitrypsin deficiency
What are the symptoms of bronchiectasis?
Persistent purulent sputum Haemoptysis (coughing up blood) Breathless Sinusitis and nasal symptoms Halitosis (bad breath) Repeated chest infection Dysponoea (breathlessness)
What are the clinical signs of bronchiectasis?
Clubbing Coarse Crackles Hypoxaemia (low blood O2) Hypercapnia (high blood Co2) None
Give some examples of pathogens that cause exacerbation
Staph A
Strep pmeumoniae
Haemophilus Influenze
Aspergillus
What investigations should be done to confirm bonchiectasis?
History
Genetics / sweat test
Ciliary beat frequency
Sperm analysis
Autoantibody screen Sputum Aspergillus antibodies Lung function CT Obstructive pattern on spirometry Blood gases
Medical intervention
Control infection and bronchial secretion
Relieve airway obstruction
Prompt antibiotic therapy
Surgery may be needed to remove sections
Nebulised antibiotics e.g. colomycin to reduce pulmonary exacerbations
Maintain body weight - nutritional support
Could a history of asthma and mucus plugs be relevant?
yes
Primary intervention?
Immunise children against measles, pertussis and other acute respiratory infection
Adult vaccination against pneumonia and influenze
Secondary intervention?
Avoid smoking
