Bronchiectasis Flashcards
1
Q
What is bronchiectasis?
A
- localised, irreversible dilation of the bronchial tree
2
Q
How would a patient with bronchiectasis present?
A
- recurrent ‘chest infections’
- recurrent antibiotic prescriptions
- no response to antibiotics
- short lived response to antibiotics
3
Q
What is the effect of bronchiectasis on the airways?
A
- dilation of airways, thickening of bronchial walls, lock of tapering of the airways
- in bronchiectasis the accompanying blood vessel is smaller than its bronchiole
4
Q
How is bronchiectasis treated?
A
- stop smoking
- flu vaccine
- pneumococcal vaccine
- reactive antibiotics: send sputum sample, give antibiotics appropriate to most recent positive culture
5
Q
How is bronchiectasis treated when the patient is colonised with persistent bacteria?
A
- oral macrolide antibiotic
- nebuliser gentamicin, colomycin
- pulsed IV abx
- alternating oral antibiotics
6
Q
Describe the anti inflammatory treatment of bronchiectasis?
A
- low dose macrolide antibiotics reduces exacerbations
- clarithromycin 250mg 1/day
- azithromycin 250mg 3/week
7
Q
How are acute exacerbations of bronchiectasis treated?
A
- 2 weeks of antibiotics appropriate to most recent positive sputum sample
- send sputum every time
- aggressively eradicate pseudomonas aeriginosa
