Bronchiectasis and Lung Abscess Flashcards Preview

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Flashcards in Bronchiectasis and Lung Abscess Deck (47):
1

Define bronchiectasis

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

2

What are the morphological changes usually accompanied by

Chronic suppurative lung disease with a cough productive purulent sputum

3

describe the inflammatory response in bronchiectasis

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

4

What leads to an accumulation of secretions

Impaired mucociliary clearance

5

What predispose to bacterial infection

Accumulated secretions

6

What does infection provoke

An inflammatory response - increased mucus production and impaired ciliary function

7

What causes tissue damage

Excessive inflammation

8

What produces dilation of bronchi and disruption of mucociliary clearance

Damage to the bronchial wall

9

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

Severe infections

10

What two causes are declining due to childhood vaccination

Pertussis (whooping cough) and measles

11

What is still a common cause of bronchiectasis in developing countries

TB

12

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

Inhalation of a foreign body

13

What should all patients with bronchiectasis have measured

Immunoglobulins IgG, IgA and IgM with serum electrophoresis

14

What should all patients with bronchiectasis have measured

Immunoglobulins IgG, IgA and IgM with serum electrophoresis

15

What is an aspergilloma

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

16

What gives rise to fleeting Xray shadows

Eosinophilic infiltrates in the lung

17

Define primary ciliary dyskinesia

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

18

What is Kartagener's syndrome

Ciliary dyskinesia with situs inversus

19

How is the definitive test for primary ciliary dyskinesia performed

Brush biopsy of nasal mucosa

20

When does cystic fibrosis usually present

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

21

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

Rheymatoid arthritis
Ulcerative colitis
Crohn's disease
Coeliac disease

22

What is the cardinal feature of bronchiectasis

Chronic cough productive of copious purulent sputum

23

Infective exacerbation of bronchiectasis may be associated with what

Fever and pleuritic pain

24

chronic severe bronchiectasis may cause what 3 things

Malaise
weight loss and
halitosis (foul breath)

25

What is sometimes present

Clubbing

26

What can be heard over affected areas

Coarse crackles

27

What is the gold standard investigation for bronchiectasis

CT scan

28

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

Sputum microbiology

29

What help to determine whether bronchodilator drugs may be helpful

Lung function tests

30

What an effective treatment in clearing secretions

Chest physiotherapy

31

What is sometimes useful in improving sputum clearance

Nebulised hypertonic saline

32

What are antibiotics used for

To suppress chronic infection and to treat exacerbations

33

When are bronchodilator drug and an inhaled steroid indicated

Where there is associated reversible airways obstruction

34

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

Surgical excision

35

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

Lung transplantation

36

WHat is a lung abscess

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

37

What does a patient with a lung abscess typically complain of

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

38

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

A fine -needle aspiration of the lesion

39

What is the most common cause of a lung abscess

Oropharyngeal aspiration

40

What is the most common cause of a lung abscess

Oropharyngeal aspiration

41

What is a key aspect of treatment with lung abscesses

Drainage of pus from the abscess cavity

42

How is drainage achieved

Bronchial drainage using postural drainage physiotherapy or
percutaneous drainage by positioning a catheter drainage tube under radiological guidance

43

What is necrobacillosis

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

44

What are lung abscesses with necrobacillosis frequently involved with

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

45

What is bronchopulmonary sequestration

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

What is required to treat bronchopulmonary sequestration

Surgical resection

47

What are the 4 treatment methods for bronchiectasis

Chest physio
Antibiotics
Inhaled bronchodilators
Specific treatment of any underlying cause