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Respiratory (LECTURE NOTES) > Bronchiectasis and Lung Abscess > Flashcards

Bronchiectasis and Lung Abscess Flashcards

1
Q

Define bronchiectasis

A

It is a chronic disease characterised by irreversible dilation of bronchi caused by bronchial wall damage resulting from infection and inflammation.

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2
Q

What are the morphological changes usually accompanied by

A

Chronic suppurative lung disease with a cough productive purulent sputum

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3
Q

describe the inflammatory response in bronchiectasis

A

ineffective in eradicating infection and a persistent cycle of chronic infection and inflammation ensues resulting in further tissue damage

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4
Q

What leads to an accumulation of secretions

A

Impaired mucociliary clearance

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5
Q

What predispose to bacterial infection

A

Accumulated secretions

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6
Q

What does infection provoke

A

An inflammatory response - increased mucus production and impaired ciliary function

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7
Q

What causes tissue damage

A

Excessive inflammation

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8
Q

What produces dilation of bronchi and disruption of mucociliary clearance

A

Damage to the bronchial wall

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9
Q

What are the most common causes of bronchial wall damage and bronchiectasis

A

Severe infections

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10
Q

What two causes are declining due to childhood vaccination

A

Pertussis (whooping cough) and measles

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11
Q

What is still a common cause of bronchiectasis in developing countries

A

TB

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12
Q

In children what might give rise to bronchial obstruction and distal bronchiectasis

A

Inhalation of a foreign body

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13
Q

What should all patients with bronchiectasis have measured

A

Immunoglobulins IgG, IgA and IgM with serum electrophoresis

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14
Q

What should all patients with bronchiectasis have measured

A

Immunoglobulins IgG, IgA and IgM with serum electrophoresis

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15
Q

What is an aspergilloma

A

A ball of fungal hyphae that appear on Xray as a mass in the centre of a cavity surrounded by a halo of radiolucency

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16
Q

What gives rise to fleeting Xray shadows

A

Eosinophilic infiltrates in the lung

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17
Q

Define primary ciliary dyskinesia

A

An autosomal recessive condition in which there is an abnormality of the ultrastructure of cilia throughout the body such that they do not beat in a coordinated fashion

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18
Q

What is Kartagener’s syndrome

A

Ciliary dyskinesia with situs inversus

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19
Q

How is the definitive test for primary ciliary dyskinesia performed

A

Brush biopsy of nasal mucosa

20
Q

When does cystic fibrosis usually present

A

In early childhood with recurrent respiratory infections and failure to thrive due to pancreatic insufficiency

21
Q

name some of the diseases which seem to have an increased incidence of bronchiectasis

A

Rheymatoid arthritis
Ulcerative colitis
Crohn’s disease
Coeliac disease

22
Q

What is the cardinal feature of bronchiectasis

A

Chronic cough productive of copious purulent sputum

23
Q

Infective exacerbation of bronchiectasis may be associated with what

A

Fever and pleuritic pain

24
Q

chronic severe bronchiectasis may cause what 3 things

A

Malaise
weight loss and
halitosis (foul breath)

25
Q

What is sometimes present

A

Clubbing

26
Q

What can be heard over affected areas

A

Coarse crackles

27
Q

What is the gold standard investigation for bronchiectasis

A

CT scan

28
Q

What should be performed to define what infective organisms are present as a guide for antibiotic treatment

A

Sputum microbiology

29
Q

What help to determine whether bronchodilator drugs may be helpful

A

Lung function tests

30
Q

What an effective treatment in clearing secretions

A

Chest physiotherapy

31
Q

What is sometimes useful in improving sputum clearance

A

Nebulised hypertonic saline

32
Q

What are antibiotics used for

A

To suppress chronic infection and to treat exacerbations

33
Q

When are bronchodilator drug and an inhaled steroid indicated

A

Where there is associated reversible airways obstruction

34
Q

what is a potential treatment for the few patients who have localised disease and troublesome symptoms

A

Surgical excision

35
Q

Where bronchiectasis has progressed to respiratory failure, what is an option

A

Lung transplantation

36
Q

WHat is a lung abscess

A

A localised collection of pus within a cavitated necrotic lesion in the lung parenchyma

37
Q

What does a patient with a lung abscess typically complain of

A

A cough with expectoration of large amount of foul material often accompanied by haemoptysis, fever, weight loss and malaise

38
Q

What may be required to distinguish between a lung abscess and other causes of cavitating lung lesions

A

A fine -needle aspiration of the lesion

39
Q

What is the most common cause of a lung abscess

A

Oropharyngeal aspiration

40
Q

What is the most common cause of a lung abscess

A

Oropharyngeal aspiration

41
Q

What is a key aspect of treatment with lung abscesses

A

Drainage of pus from the abscess cavity

42
Q

How is drainage achieved

A

Bronchial drainage using postural drainage physiotherapy or

percutaneous drainage by positioning a catheter drainage tube under radiological guidance

43
Q

What is necrobacillosis

A

An unusual cause of lung abscess that is associated with a very characteristic clinical picture first described by Limiere

44
Q

What are lung abscesses with necrobacillosis frequently involved with

A

Multiple abscesses forming often with a pleural empyema and evidence of infection elsewhere

45
Q

What is bronchopulmonary sequestration

A

A congenital anomaly in which an area of lung is not connected to the bronchial tree and has an anomalous blood supply usually from the aorta

46
Q

What is required to treat bronchopulmonary sequestration

A

Surgical resection

47
Q

What are the 4 treatment methods for bronchiectasis

A

Chest physio
Antibiotics
Inhaled bronchodilators
Specific treatment of any underlying cause

Respiratory (LECTURE NOTES) (19 decks)

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