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Respiratory Exam
 
 

Bronchiectasis

July 1st, 2020
 
 
 
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Overview

  • 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
  • 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
  • Complications of Bronchiectasis

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