Bronchiectasis, D Kinder, DSA Flashcards
bronchiectasis
abnormal permanent dilatation of the bronchi and bronchioles from airway infection and inglammatoin
have defects in mucous clearance and drainage.
chronic infections lead to lung destruction
half patients with bronchiectasis have what
CF
What are the infectious etiologies behind bronchiectasis
childhood pertussis, TB, mycobacterium avium intracellulare
MAI infection infects lungs where
right middle lobe and lingula
What genetic etiologies can lead to bronchiectasis
CF, primary ciliary dyskinesia, alpha 1 antitrypsin deficiency
What are anatomic causes of bronchiectasis
esophageal dysfunction with aspiration, COPD, allergic bronchopulmonary aspergillosis, endobronchial tumors, extrinsic compression by lymph nodes and foreign bodies
What immune etiologies can lead to bronchiectasis
hypogammaglobulinemia, IgG deficiencies, HIV, Sjogrens syndrome and RA
Sx of bronchiectasis
chronic cough with purulent sputum, dyspnea, intermittent hemoptysis, pleuritic chest pain, weight loss and fatigue
wheezing and crackles
What is used to make Dx of bronchiectasis
High resolution CT
What will CT show with bronchiectasis
bronchial tapering, bronchi visible in peripher 1 vm of lungs
internal bronchial diameter is greater than that of accompanying bronchial artery
What lobes are affected in bronchiectasis
upper lobe with CF
lower lobe with aspiration
right middle lobe and lingular lobe with MAI infections
central bronchiectasis with allergic bronchopulmonary aspergillosis
PFT of bronchiectasis
obstruction
What tests to order for suspected bronchiectasis
PFT
bronchoscopu to look for obstructive causes
sputum cultures
high res CT
Tx bronchiectasis
1 treat underlying condition
2 specific antimicrobials
3 anti-inflammatory- inhaled steroids or macrolide antibiotics
4 mobilization of secretions- pharm or mechanical
5 surgery for localized or refractory disease
6 transplantation for end stage disease
