chronic lung disease Flashcards
what is bronchiectasis characterized by ?
permanent dilatation of the bronchi with inflammation and accumulation of exudate
what is the etiology of bronchiectasis ?
congenital
Acquired
what are the acquired causes of bronchiectasis ?
- infection : TB, CF, post infectious
- obstruction: neglected foreign body, lymph node compression
- chronic aspiration
what is the clinical picture of bronchiectasis ?
chronic wet cough
copious purulent sputum
clubbing, poor weight gain
what is the causative agent in TB ?
mycobacterium tuberculosis
what are the different presentations of pulmonary TB ?
primary infection can be either symptomatic or asymptomatic ( latent)
what is the presentation of a symptomatic pulmonary TB patient ?
pneumonia and lymph node enlargement
fever, cough, anorexia and weight loss and night sweats
what does a chest x ray of pulmonary TB show ?
pleural effusion
consolidation
hilar lymph node affection
what is post primary TB ?
reactivation of latent TB infection
in the form of extra-pulmonary manifestations
arthritis , meningitis, military TB
no LN enlargement
how is MTB detected ?
either culture and using a ZN stain
or PCR
what are the lab tests required to diagnose TB ?
- mantoux test / TST : enduration is measured and can be positive after BCG
- IGRA can also be used and will not be positive for BCG
what is the treatment for TB ?
combination treatment for 3 months of : isoniazid, rifampcin, ethambutol and pyrazinamide
followed by 6 months of isoniazid and rifampcin
what is the treatment for latent TB ?
3 months of isoniazid and rifampcin or 6 months of isoniazid
what type of vaccine is the BCG ?
live attenuated
when is BCG taken ?
first month of life then a booster at 6 years
what is the chemoprophylaxis for close contacts of TB ?
isoniazid
what is NTM ?
non tuberculous mycobacterium is cause by MAC , non contagious affects immunocompromised individuals with pre-existing lung diseases such as CF
what is the method of inheritance of CF ?
autosomal recessive
what is the gene mutation associated with CF ?
CFTR gene
what are the manifestations of CF in newborns ?
meconium ileus
prolonged jaundice
FTT
malabsorption steatorrhea
what are the multisystem affections of CF ?
nasal polyps
steatosis
pancreatic insufficiency
swelling of submandibular or parotid glands
how is a diagnosis of CF made ?
sweat chloride test >60 mmol
heel prick test - IT (immunoreactive trypsin) positive
positive fecal elastase in pancreatic insufficiency
CFTR gene analysis
what is primary ciliary dyskinesia ?
impaired mucociliary clearance
what is the presentation of primary ciliary dyskinesia ?
chronic cough
chronic sinusitis
chronic ear discharge
