bronchiectasis + sarcoidosis Flashcards
(10 cards)
bronchiectasis
permanent dilatation of airways secondary to chronic infection or inflammation
causes of bronchiectasis
post-infective - pertussis, pneumonia
cystic fibrosis
bronchial obstruction - lung cancer/foreign body
immune deficiency
allergic bronchopulmonary aspergillosis
ciliary dyskinetic syndromes
bronchiectasis features
persistent productive cough - large volumes of sputum
dyspnoea
haemoptysis
coarse crackles, wheeze
clubbing
signet rings, enlarged bronchi on chest CT
bronchiectasis management
physio - inspiratory muscle training - for non-CF patients
postural drainage
abx for exacerbations
immunisations
commonest organisms isolated from patients with bronchiectasis
haemophilus influenzae = commonest
pseudomonas aeruginosa
klebsiella spp.
streptococcus pneumoniae
sarcoidosis
multisystem disorder of unknown aetiology characterised by non-caseating granulomas
commoner in young adults + people of african descent
sarcoidosis features
acute;
- erythema nodosum
- bilateral hilar lymphadenopathy
- swinging fever
- polyarthralgia
insidious - dyspnoea. non-productive cough, malaise, weight loss
hypercalcaemia - macrophages inside granulomas cause an increased conversion of vit D to its active form
sarcoidosis investigations
increased ACE levels
hypercalcaemia
raised ESR
CXR - bilateral lymph adenopathy, interstitial infiltrates
spirometry - restrictive
tissue biopsy = non-caseating granuloma
management of sarcoidosis and indications for this
steroids!
indications;
- symptomatic, more severe disease (stage 2 or 3)
- hypercalcaemia
- eye, heart or neuro involvement
those with just bilateral hilar lymphadenopathy alone dont require (stage 1)
factors assoc with poor prognosis in sarcoidosis
- insidious onset
- absence of erythema nodosum
- extrapulmonary manifestations - splenomegaly
- late stages of disease
- black or afro caribbean ethnicity
