Bronchiectasis (superlative disease)

Question 1

What is bronchiectasis?

Answer 1

The permanent abnormal dilation in one or more of-the lung bronchi. Extra mucus is secreted and pools in the areas of the airways that are dilated making the person more prone to infection.

Question 2

Who is normally affected?

Answer 2

Mostly female, elderly people.

Question 3

What are the steps?

Answer 3

1. Impaired mucocilliary clearance leads to accumulation of secretions.
2. Leads to infection by bacteria
3. Infection by bacteria Leads to mucus production, which leads to impaired ciliary performance, which leads to inflammatory response.
4. Excessive inflammatory response causes tissue damage.
5. Tissue damage produces dilated bronchi including loss of ciliates epithelium and impaired mucocillary clearance…. cycle continues(back to stage 1)

Question 4

What causes bronchiectasis?

Answer 4

Mostly unknown, infections in child hood causing longterm damage, cystic fibrosis, immunodeficiency, ciliary dysfunction, inflammation conditions, obstructions.

Question 5

What are the clinical features?

Answer 5

Wet Coughs and sputum production,
Dyspnoea (SOB) and wheeze,
Chest pain due to constant coughing,
Chronic sinusitis, and nasal polyps.
Haemoptysis (coughing up blood).

Question 6

How do we diagnose bronchiectasis?

Answer 6

Chest X-rays,
High resolution computed tomography (HRCT),
Blood sputum microbiology,
Pulmonary functions test,

Question 7

What are the types of bronchiectasis?

Answer 7

Saccular
(occurs in large bronchi that become large and ballon like)
Cylindrical
(occurs in medium sized bronchi, usually symmetrically dilated)
Varicose
(constrictions and dilutions deform bronchi)

Question 8

What are the symptoms of acute exacerbation?

Answer 8

Changes in sputum production.
Increases SOB (dyspnoea).
Increased cough.
High Temperatures .
Increased wheezing.
Fatigue.
X-ray changes comparing new to old.
Changes in chest sound.

Question 9

What a are treatments and managements for bronchiectasis?

Answer 9

Physiotherapy helping in chest clearance.
IV/nebulaised antibiotics.
Bronchodilators to reduce tightness.
Steroids.
Nasal spray.
Surgery.
Pneumococcal vaccinations/ flu.