Bronchiectasis, CF, aspergillosis Flashcards
Congenital risk factors for bronchiestasis
CF
Kartagener’s/Primary ciliary dyskinesia - dextrocardia
Young syndrome - ciliary hairs normal but mucous abnormally thick
Post-infectious causes of bronchectasis
Measles, pertussis, pneumonia, TB, bronchilitis
Features of yellow nail syndrome (another cause of bronchiectasis)
Yellow nail discolorisation + dystrophy
Lymphopenia
Bronchiectsis
Pleural effusions
Complications of bronchiectasis
Pneumonia, pleural effusion
Pneumothorax, pulmonary HTN
Massive haemoptysis, cerebral abscess, amyloidosis
CXR, spirometry and HRCT results in bronchiectasis
CXR - thickened bronchial walls (tramlines+rings)
Spirometry - Obstructive
HRCT - dilated + thickened airways
Treat bronchiectasis
Chest physio, abx for exacerbation, bronchodilator
Systemic conditions linked to bronchiectasis
Rheumatoid arthritis, ABPA, hypogammaglobuminaemia
Clinical features of CF as neonate
FTT, meconium ileus, rectal prolapse
Nose and resp features of CF as children
Nose - nasal polyps, sinusitis
Resp - cough, wheeze, infections, cor pulmonale
GI and other CF features
Other - male infertility, osteoporosis, vasclitis
Pancreatic insufficiency, DM, steatorrhoea
Gallstones, cirrhosis
Distal intestinal obstruction syndrome
Dx CF
Sweat test - Na and Cl >60mM
Genetic screening for common mutations
Immunoreactive trypsinogen (neonatal)
Mx CF
MDT, chest physio, antibiotics, mucolytics
Pancreatic enzyme replacement, ADEK supplements, inuslin
Ursodeoxycholic acid (for impaired hepatic impairment)
Pulmonary aspergillus infections
Asthma, ABPA, aspergilloma, invasive aspergillosis, EAA
Ix in allergic bronchopulmonary aspergillosis
CXR - bronchiectasis
Aspergerillus in sputum - black on silver stain
Aspergillus skin test/IgE RAST
Raised IgE and eosinophils
Mx in ABPA
Acute - Pred 40mg + itraconzaole
Pred maintenance
