Bronchiectasis Flashcards
(16 cards)
What is bronchiectasis
Chronic lung disease characterised by persistent, irreversible dilatation and damage of bronchi in due to inflammation/infection
May be diffuse or localised
Causes of bronchiectasis?
No identifiable cause (most common)
Previous severe LRTI is most common identifiable cause
Immunodeficiency
Alpha 1 antitrypsin deficiency
Defective mucociliary clearance
Allergic bronchopulmonary aspergillosis
Autoimmune disease
Airway obstruction
Chronic aspiration
Congenital large airway defects
Yellow nail syndrome
What are examples of conditions that cause mucociliary clearance that can lead to bronchiectasis?
Cystic fibrosis
Kartagener syndrome
What are examples of autoimmune conditions that can lead to bronchiectasis
RA
SLE
IBD
Sjorens
What are examples of congenital conditions that can lead to bronchiectasis
Marfans
Tracheobronchomegaly
What are the features of yellow nail syndrome?
Yellow nails
Lymphoedema
Bronchiectasis
Signs and symptoms of bronchiectasis?
CHRONIC COUGH (MIN. 8 WEEKS)
COPIOUS foul smelling purulent sputum
Dyspnoea
Haemoptysis
Chest pain
RECURRENT CHEST INFECTIONS
Fatigue
Weight loss
Signs:
Coarse crackles on auscultation
Wheeze
Rhonci
Clubbing
What is rhonci?
Snoring sounds caused by large airway secretions
Investigations for bronchiectasis?
Sputum culture
Spirometry - look for corbid asthma + COPD, assess obstruction severity
WCC, CRP bloods
CXR
High resolution CT chest
Tests for underlying cause
What findings on CXR are characteristic of bronchiectasis?
Tram track opacities
Ring shadows
Increased lung markings
What is the most common infective organism seen in bronchiectasis?
Haemophilus influenza
What findings on CT would be characteristic of bronchiectasis?
Lack of airway tapering
Increased ratio of bronchi to pulmonary arteries
Bronchial wall thickening
Impacted mucus
Management of bronchiectasis?
Conservative:
- Pneumococcal and flu vaccine
- Respiratory physio
- Smoking cessation
- Nutritional support if BMI <20
- Patient education on self management eg sputum clearance exercises
Medical:
- Antibiotics during acute exacerbations
- Long-term antibiotic prophylaxis if 3+ exacerbations per year or exacerbations causing significant morbidity
- Manage comorbidities
Surgical:
- Lung resection if localised
- Lung transplant if no response to medical management
What drug would you give to treat pseudomonas aeruginosa?
Ciprofloxacin
Complications of bronchiectasis?
Recurrent infections
Life threatening haemoptysis
Cor pulmonale
What abnormality is Kartegener syndrome associated with
Dextrocardia
