Bronchiectasis Flashcards
What is bronchiectasis?
Chronic dilatation + thickening of one or more bronchi
What is the effect of bronchiectasis?
Poor mucus clearance
Chronic bacterial infection
What can cause bronchiectasis?
Pneumonia TB Influenza Immunodeficiency Aspiration Steroid use Cystic fibrosis RA Allergic bronchopulmonary aspergillosis
What is ABPA?
Allergic bronchopulmonary aspergillosis
Type 1 and 3 hypersensitivity reaction to aspergillus
What are the symptoms of bronchiectasis?
Purulent sputum Cough Haemoptysis Breathlessness Recurrent infections Wheeze Course crackles
What are the investigations for suspected bronchiectasis?
Sputum sample Peak flow Bloods ABG CXR Bronchoscopy HRCT
What is the gold standard investigation?
HRCT
What can be seen on a HRCT?
Signet ring sign - increased bronchoarterial ratio
Bunch of grapes - dilated bronchi
Tram tracks - thickened non-tapering walls
What are the different classifications of bronchiectasis?
Cylindrical
- bronchi have a uniform calibre, do not taper and have parallel walls
Varicose
- beaded appearances where dilated bronchi have interspersed sites of relative narrowing
Saccular/cystic
- severe form with cyst-like bronchi that extend to the pleural surface
- seen in cystic fibrosis
How is bronchiectasis managed?
Treat underlying cause
MDT
Smoking cessation
Bronchodilators
Chest physio
How are infective exacerbations of bronchiectasis managed?
Antibiotics
Steroids
What are complications of bronchiectasis?
Cor pulmonale
Sepsis
Abscesses
Respiratory failure
