×
MedSchool: Ace Your OSCEsThe Medical Company
 
 
 
 
 
GET - On the App Store
View
Lower Respiratory Disease
 
Lower Respiratory Disease
 

Bronchiectasis

 
 
 
Bookmark

Pathogenesis

  • Causes of Bronchiectasis

  • Congenital

  • Cystic fibrosis
  • Primary ciliary dyskinesia (e.g. Kartegener’s syndrome)
  • Hypogammaglobulinaemia
  • Acquired

  • Recurrent pneumonia (e.g. in the setting of immunosuppression) - bacterial, tuberculous, fungal
  • Chronic obstructive pulmonary disease (COPD)
  • Allergic bronchopulmonary aspergillosis (ABPA)
  • Autoimmune diseases - rheumatoid arthritis, Sjogren’s syndrome, ulcerative colitis
  • Chronic aspiration (e.g. secondary to gastroesophageal reflux)
  • Airway foreign body

Manifestations

  • Complications of Bronchiectasis

  • Acute exacerbations
  • Pulmonary haemorrhage
  • Pneumothorax
  • Empyema
  • Lung abscess
  • Cor pulmonale

Diagnosis

  • Signs of Bronchiectasis

  • Oxygen requirement - reduced SpO2, nasal prongs
  • Halitosis
  • Cough - moist
  • Sputum - purulent / haemoptysis
  • Clubbing
  • Central cyanosis
  • Coarse crepitations
  • Wheeze
  • Signs of Complications

  • Evidence of empyema - dull percussion note, reduced breath sounds, reduced vocal resonance
  • Evidence of right ventricular failure - raised JVP, ascites, pleural effusions, peripheral oedema
  • Evidence of pulmonary hypertension - raised JVP, parasternal heave, loud / palpable P2
  • Complications of Bronchiectasis

  • Acute exacerbations
  • Pulmonary haemorrhage
  • Pneumothorax
  • Empyema
  • Lung abscess
  • Cor pulmonale

Management

  • Management Strategy

  • Treat the underlying cause
  • Sputum clearance - bronchodilators, mucolytics, hypertonic saline, physiotherapy, postural drainage
  • Reduce inflammation - using macrolides (azithromycin)
  • Manage infection - monitor for colonisation, consider antimicrobial prophylaxis
  • Vaccinations - influenza, pneumococcus
  • Nutritional support
  • Home oxygen
  • Lung transplant
Next Page
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge
Sign Up Now
   
 
 

Snapshot: Initialising...