Bronchiectasis - Slocum

Question 1

Defined as

Answer 1

disease caused by multiple cycles of infection and subsequent inflammation in the bronchi and bronchioles that results in permanent fibrosis, remodeling, and dilation of middle airways

Question 2

Associated with history of what other conditions?

Answer 2

• Chronic infection (TB, pseudomonas, H flu, s.pneumo, Staph
• localized airway obstruction: tumor or inhaled foreign object
• Reactive airway disease (asthma)
• Hypersensitivity
• aspiration
• CF
• RA, SLE
• IBD
• immunodeficiency

Question 3

Signs and symptoms

Answer 3

• chronic, productive cough
• purulent, yellow or green sputum
• hemoptysis

Question 4

Physical exam findings

Answer 4

• rales
• wheezes
• rhonchi
• purulent mucus
• foul breath

Question 5

CXR findings

Answer 5

• increased bronchovascular markings
• tram-track lines (parallel lines outlining the dilated bronchi secondary to chronic, peribronchial inflammation and fibrosis)
• Honeycombing

Question 6

what are you likely to see on CT/

Answer 6

• thickened bronchiole walls with dilated airways

- ballooned cysts at distal end of bronchi

Question 7

PFT findings

Answer 7

decreased FEV1/FVC ratio

Question 8

Treatment

Answer 8

ABX: amoxicillin or amox-clav; ampicillin or tetracycline, TMP-SMX

• supplemental O2 when SaO2 >90%
• ICS as adjunct to supplemental O2
• Hand-held flutter valve device: chest physiotherapy in clearing secretions
• Lobectomy in severe localized disease
• lung transplantation in terminal cases