L8: Suppurative Lung Diseases Flashcards by Ahmed Farag

Q

Def of SLD

A

Pulmonary diseases characterized by cough and expectoration that is usually copious, and
related to posture and time.

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Q

Types of SLD

A

Bronchiectasis.
Lung abscess.
Empyema with bronchopleural fistula.
Infected cystic lung.

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Q

Def of Bronchiectasis

A

Persistent (irreversible) dilatation of the medium sized bronchi due to destruction of epithelial, elastic and muscular elements of bronchi.

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Q

Morphological Types of Bronchiectasis

A

Cylindrical or tubular
Saccular (cystic).
Fusiform
Varicose (tortuous).

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Q

Etiology of Bronchiectasis

A

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Q

Etiology of Bronchiectasis

Congenital

A

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Q

Etiology of Bronchiectasis

Ciliary dyskinesia syndromes (Immotile cilia syndrome)

A

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Q

Etiology of Bronchiectasis

Acquired

A

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Q

Acquired Causes of Bronchiectasis

Airway Obstruction

A

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Q

Acquired Causes of Bronchiectasis

Post-Infectious

A

Tuberculosis
Bacterial pneumonia
Pertussis
Measles and influenza

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Q

CP of Bronchiectasis

A

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Q

CP of Bronchiectasis

Symptoms

A

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Q

Symptoms of Bronchiectasis

Cough and expectoration

A

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Q

Symptoms of Bronchiectasis

Hemoptysis

A

Common in upper lobes (e. g. post -TB).
It may be massive and recurrent.

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Q

Symptoms of Bronchiectasis

Recurrent pleuritic chest pain

A

Recurrent pleuritic chest pain and pneumonia at the same site.

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Q

Symptoms of Bronchiectasis

Wheezy Chest

A

Uncommon but may be present.

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Q

Symptoms of Bronchiectasis

Dyspnea

A

Present late in the course of the disease
Indicates wide spread lung disease.

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Q

Symptoms of Bronchiectasis

General Manifestations

A

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Q

Signs of Bronchiectasis

A

Q

Signs of Bronchiectasis

Mild & Early Stages

A

No signs especially in mild & early stage bronchiectasis.

Q

Signs of Bronchiectasis

Clubbing

A

Digital clubbing

Q

Signs of Bronchiectasis

At the time of infective exacerbation

A

Fever
Increased respiratory rate
Anemia
Toxemic manifestations

Q

Signs of Bronchiectasis

Crackels

A

Q

Complications of Bronchiectasis

A

DDx of **Bronchiectasis**

INVx for **Bronchiectasis**

INVx for **Bronchiectasis** - Rads

- Plain x-ray chest - High resolution CT (HRCT): gold stander investigation

INVx for **Bronchiectasis** - Labs

- Sputum Gram stain and Culture: for infecting organism(s). - Pulmonary Function Tests (PFTs)

INVx for **Bronchiectasis** - Bronchoscopy

- To assess cause of obstruction

INVx for **Bronchiectasis** - Others

Treatment of **Bronchiectasis**

Treatment of **Bronchiectasis** - Supportive

Treatment of **Bronchiectasis** - O2

Oxygen therapy is reserved for patients who are: - Hypoxemic with severe disease and end-stage complications, such as cor pulmonale.

Treatment of **Bronchiectasis** - Medical

Antibiotics in **Bronchiectasis** - Value

The main line of therapy in bronchiectasis

Antibiotics in **Bronchiectasis** - Route

- Oral, - Parenteral, - Aerosolized

Antibiotics in **Bronchiectasis** - Examples

Antibiotics in **Bronchiectasis** - Acceptable choices for the outpatient who is mild to moderately ill include .....

- Amoxicillin, - Tetracycline - Trimethoprim-sulfamethoxazole.

Antibiotics in **Bronchiectasis** - Ciprofloxacin, aminoglycosides and ceftazidime

- Cover gram negative organisms as Pseudomonus aerogenosa which colonize the bronchial tree of advanced forms of bronchiectasis

Antibiotics in **Bronchiectasis** - Antibiotic against anaerobes (metronidazole and clindamycin)

- Added in suspected anaerobic infection (by fetid odor)

Antibiotics in **Bronchiectasis** - Culture and sensitivity of protected samples taken via fiberoptic bronchoscope (FOB) in immunocompromized patients

....

TTT of **Bronchiectasis** - Postural Drainage

TTT of **Bronchiectasis** - Others (Acc to cause)

TTT of **Bronchiectasis** - TTT of Complications

- Mechanical ventilation for respiratory failure. - Intercostal tube drainage under water seal for pneumothorax and empyema.

TTT of **Bronchiectasis** - TTT of Cause

TTT of **Bronchiectasis** - Embolic Therapy

Indicated in cases of massive hemoptysis to control bleeding

TTT of **Bronchiectasis** - Surgical TTT

- Lobectomy, - Pneumonectomy - Lung transplantation