Pulmonology - Bronchiectasis Flashcards
(14 cards)
Local infection or inflammation AND either inadequate clearance of secretions, airway obstruction, or impaired host defenses resulting in permanent dilation of airways
Bronchiectasis
Disorders of secretion clearance or mucous plugging
- cystic fibrosis
- primary ciliary dyskinesia
- allergic bronchopulmonary aspergillosis
- smoking (associated with poor ciliary motility)
Primary prevention of bronchiectasis in predisposed individuals
Antibiotic control of bronchial and pulmonary infections
Hallmark of bronchiectasis
Chronic productive cough (lasting months to years) with copious mucopurulent sputum
What is the best initial test for bronchiectasis?
Chest Xray
What imaging study is used to confirm diagnosis in patients suspected of bronchiectasis?
High resolution CT scan (HRCT)
Findings of bronchiectasis
Bronchial dilation, Parallel tram track sign and signet ring sign, thickened bronchial walls
What finding suggests late stage bronchiectasis?
Honeycombing
Management of acute exacerbations
Obtain new sputum culture and start empiric antibiotics
Long term management of bronchiectasis
- smoking cessation
- bronchopulmonary hygiene and chest physiotherapy
- vaccinations (influenza, pneumococcal)
When is antibiotic prophylaxis considered?
For patients with 3+ exacerbations per year, administered for at least 3 months
When is surgical resection indicated?
- pulmonary hemorrhage
- inviable bronchus
- poor control of symptoms despite optimal medical therapy in unilateral bronchiectasis with well-localized disease
Complications of bronchiectasis
- respiratory failure
- cor pulmonale
- pulmonary hemorrhage (massive hemoptysis)
- lung abscess
Cross sectional bronchial diameter exceeding that of the adjacent pulmonary artery branch
Signet ring sign
