Patho 2- Bronchiectasis

Question 1

Definition of Bronchiectasis

Answer 1

Permanent abnormal dilation in one or more of the lungs bronchi.
Extra mucus secreted in dilated airways, more prone to infection.
Similar symptoms to COPD- not always obstruction

Question 2

Pathogenesis of Bronchiectasis

Answer 2

Impaired mucocilliary clearance leads to secretion accumulation
Leads to infection by bacteria
Leads to increased mucus production, impaired cilliary performance and inflammatory response.
Causes tissue damage
Producing dilated bronchi including loss of cilited epithelium and impaired mucocilliary clearance

Question 3

Damaged caused by Bronchiectasis

Answer 3

Loss of cilia
Increased mucus
Destruction of wall

Question 4

Causes of Bronchiectasis

Answer 4

Idiopathic
Infection
CF
Immunodeficiency 
Cilliary dysfunction 
Allergic bronchopulmonary aspergillosis 
Inflammatory conditions 
Apsiration/obstruction

Question 5

Clinical features of Bronchiectasis

Answer 5

Cough/chronic sputum production
Dyspnoea and wheeze
Chest pain
Signs of chronic sinusitis and nasal polyps
Recurrent exacerbations 
Experience haemoptysis

Question 6

Diagnosis of Bronchiectasis

Answer 6

CXR
high resolution comouted tomography
Blood and sputum microbiology
PFT

Question 7

Types of Bronchiectasis

Answer 7

Saccular (large bronchi)
Cylindrical (medium bronchi)
Varicose (constrictions and dilations deform bronchi)

All can be local or widespread

Question 8

Symptoms of acute exacerbations

Answer 8

Change in sputum production
Increased dyspnoea
Increased cough
Temp >38
Increased wheezing 
Malaise, fatigue, lethargy and decreased exercise tolerance
Decreased pulmonary function 
X ray changes consistent with new pulmonary process
Changes in chest sounds

Question 9

Treatment and management of Bronchiectasis

Answer 9

Physio
IV/Oral/nebulised antibiotics
Bronchodilators 
Steroids
Nasal sprays
Flu and pneumococcal vaccines 
Surgery