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Questions and Answers
Which of the following is the hallmark characteristic of bronchiectasis?
Which of the following is the hallmark characteristic of bronchiectasis?
- Intermittent spasms of the diaphragm
- Transient constriction of the bronchioles
- Permanent dilation of the bronchi (correct)
- Temporary inflammation of the trachea
Bronchiectasis is characterized by a dry cough and minimal sputum production.
Bronchiectasis is characterized by a dry cough and minimal sputum production.
False (B)
What imaging technique is the preferred method for diagnosing bronchiectasis?
What imaging technique is the preferred method for diagnosing bronchiectasis?
High-resolution CT (HRCT)
Yellow nail syndrome is characterized by yellow fingernails, bronchiectasis, and _________.
Yellow nail syndrome is characterized by yellow fingernails, bronchiectasis, and _________.
Which of the following is a common causative organism in bronchiectasis infections?
Which of the following is a common causative organism in bronchiectasis infections?
Long-term antibiotic use is typically avoided in bronchiectasis management due to the risk of antibiotic resistance.
Long-term antibiotic use is typically avoided in bronchiectasis management due to the risk of antibiotic resistance.
Name two typical findings on a chest X-ray that may suggest bronchiectasis.
Name two typical findings on a chest X-ray that may suggest bronchiectasis.
For infective exacerbations in bronchiectasis caused by Pseudomonas aeruginosa, the usual antibiotic of choice is _________.
For infective exacerbations in bronchiectasis caused by Pseudomonas aeruginosa, the usual antibiotic of choice is _________.
Which of the following signs is NOT commonly associated with bronchiectasis?
Which of the following signs is NOT commonly associated with bronchiectasis?
Surgical lung resection is a first-line treatment for all patients with bronchiectasis.
Surgical lung resection is a first-line treatment for all patients with bronchiectasis.
Besides antibiotics, what is another key component of bronchiectasis management aimed at clearing sputum?
Besides antibiotics, what is another key component of bronchiectasis management aimed at clearing sputum?
Patients with bronchiectasis and reduced oxygen saturation may require _________.
Patients with bronchiectasis and reduced oxygen saturation may require _________.
A patient with bronchiectasis experiences frequent exacerbations (more than 3 per year) despite optimal management. Which long-term medication is most appropriate to consider?
A patient with bronchiectasis experiences frequent exacerbations (more than 3 per year) despite optimal management. Which long-term medication is most appropriate to consider?
Cor pulmonale, a potential complication of bronchiectasis, primarily affects the left side of the heart.
Cor pulmonale, a potential complication of bronchiectasis, primarily affects the left side of the heart.
What specific inhaled medication is typically used for Pseudomonas aeruginosa colonization in bronchiectasis patients?
What specific inhaled medication is typically used for Pseudomonas aeruginosa colonization in bronchiectasis patients?
Individuals with bronchiectasis should receive vaccinations against pneumococcal infections and _________ to reduce the risk of respiratory infections.
Individuals with bronchiectasis should receive vaccinations against pneumococcal infections and _________ to reduce the risk of respiratory infections.
A 55-year-old patient with bronchiectasis and chronic Pseudomonas aeruginosa infection develops increased dyspnea and purulent sputum. Despite being on inhaled colistin, their condition worsens. What is the next best step in management?
A 55-year-old patient with bronchiectasis and chronic Pseudomonas aeruginosa infection develops increased dyspnea and purulent sputum. Despite being on inhaled colistin, their condition worsens. What is the next best step in management?
Alpha-1-antitrypsin deficiency primarily leads to bronchiectasis due to its direct toxic effect on bronchial smooth muscle.
Alpha-1-antitrypsin deficiency primarily leads to bronchiectasis due to its direct toxic effect on bronchial smooth muscle.
In the context of bronchiectasis, explain how 'tram-track opacities' arise on a chest X-ray.
In the context of bronchiectasis, explain how 'tram-track opacities' arise on a chest X-ray.
In a patient with bronchiectasis and suspected cor pulmonale, elevated _________ and peripheral oedema are key clinical signs to look for during physical examination.
In a patient with bronchiectasis and suspected cor pulmonale, elevated _________ and peripheral oedema are key clinical signs to look for during physical examination.
Which of the following best describes the primary characteristic of bronchiectasis?
Which of the following best describes the primary characteristic of bronchiectasis?
Bronchiectasis is primarily caused by a genetic predisposition, with environmental factors playing a minimal role.
Bronchiectasis is primarily caused by a genetic predisposition, with environmental factors playing a minimal role.
List three potential causes of damage to the airways that can result in bronchiectasis.
List three potential causes of damage to the airways that can result in bronchiectasis.
Match the following clinical signs with their potential association with bronchiectasis:
Match the following clinical signs with their potential association with bronchiectasis:
Which of the following is a key presenting symptom of bronchiectasis?
Which of the following is a key presenting symptom of bronchiectasis?
The presence of a 'sputum pot' by the bedside is an uncommon sign in patients with bronchiectasis.
The presence of a 'sputum pot' by the bedside is an uncommon sign in patients with bronchiectasis.
Name two signs of cor pulmonale that might be observed in a patient with bronchiectasis.
Name two signs of cor pulmonale that might be observed in a patient with bronchiectasis.
Scattered ________ throughout the chest that change or clear with coughing is a sign of bronchiectasis.
Scattered ________ throughout the chest that change or clear with coughing is a sign of bronchiectasis.
Match the following chest x-ray findings with their description in bronchiectasis:
Match the following chest x-ray findings with their description in bronchiectasis:
Which of the following is the test of choice for establishing a diagnosis of bronchiectasis?
Which of the following is the test of choice for establishing a diagnosis of bronchiectasis?
Sputum culture is not useful in the diagnostic workup of bronchiectasis.
Sputum culture is not useful in the diagnostic workup of bronchiectasis.
Name two common infective organisms identified via sputum culture in bronchiectasis
Name two common infective organisms identified via sputum culture in bronchiectasis
Parallel markings of a side-view of the dilated airway on a chest x-ray are referred to as ________ opacities.
Parallel markings of a side-view of the dilated airway on a chest x-ray are referred to as ________ opacities.
Match the following management strategies with their primary role in bronchiectasis:
Match the following management strategies with their primary role in bronchiectasis:
Which of the following vaccines is typically recommended as part of the general management of bronchiectasis?
Which of the following vaccines is typically recommended as part of the general management of bronchiectasis?
Long-term antibiotics are typically prescribed for bronchiectasis only in patients experiencing infrequent exacerbations.
Long-term antibiotics are typically prescribed for bronchiectasis only in patients experiencing infrequent exacerbations.
Name two potential pharmaceutical treatments for frequent exacerbations of bronchiectasis.
Name two potential pharmaceutical treatments for frequent exacerbations of bronchiectasis.
Inhaled ________ is often prescribed for patients with bronchiectasis who have Pseudomonas aeruginosa colonisation.
Inhaled ________ is often prescribed for patients with bronchiectasis who have Pseudomonas aeruginosa colonisation.
Match the following scenarios with the appropriate duration of antibiotics:
Match the following scenarios with the appropriate duration of antibiotics:
Which antibiotic is typically chosen for exacerbations caused by Pseudomonas aeruginosa?
Which antibiotic is typically chosen for exacerbations caused by Pseudomonas aeruginosa?
Surgical lung resection is a first-line treatment option for all patients with bronchiectasis.
Surgical lung resection is a first-line treatment option for all patients with bronchiectasis.
In addition to antibiotics, what other therapeutic intervention is crucial during infective exacerbations of bronchiectasis?
In addition to antibiotics, what other therapeutic intervention is crucial during infective exacerbations of bronchiectasis?
For breathlessness, ________ bronchodilators may be considered for patients with bronchiectasis.
For breathlessness, ________ bronchodilators may be considered for patients with bronchiectasis.
Match the management strategy with the stage of disease:
Match the management strategy with the stage of disease:
A patient with yellow fingernails, bronchiectasis, and lymphoedema most likely has which condition?
A patient with yellow fingernails, bronchiectasis, and lymphoedema most likely has which condition?
Weight gain is a typical sign associated with bronchiectasis.
Weight gain is a typical sign associated with bronchiectasis.
What imaging modality is used to visualize tram-track opacities and ring shadows in bronchiectasis?
What imaging modality is used to visualize tram-track opacities and ring shadows in bronchiectasis?
_____ rehabilitation can help improve exercise tolerance and quality of life in patients with bronchiectasis.
_____ rehabilitation can help improve exercise tolerance and quality of life in patients with bronchiectasis.
Match the following investigations with the corresponding infective organism:
Match the following investigations with the corresponding infective organism:
A patient with bronchiectasis has frequent exacerbations, despite adherence to physiotherapy and vaccinations. What is the next most appropriate step?
A patient with bronchiectasis has frequent exacerbations, despite adherence to physiotherapy and vaccinations. What is the next most appropriate step?
Long-term oxygen therapy is not indicated for bronchiectasis.
Long-term oxygen therapy is not indicated for bronchiectasis.
What is the usual length of antibiotic courses for infective exacerbations of bronchiectasis?
What is the usual length of antibiotic courses for infective exacerbations of bronchiectasis?
The presence of both scattered wheezes and scattered ________ throughout the chest are clinical signs of bronchiectasis
The presence of both scattered wheezes and scattered ________ throughout the chest are clinical signs of bronchiectasis
Match the following signs with their diagnostic purpose:
Match the following signs with their diagnostic purpose:
Which of the following findings on chest auscultation is least likely to be associated with bronchiectasis?
Which of the following findings on chest auscultation is least likely to be associated with bronchiectasis?
A normal chest x-ray completely rules out the possibility of bronchiectasis.
A normal chest x-ray completely rules out the possibility of bronchiectasis.
List three presenting symptoms of bronchiectasis.
List three presenting symptoms of bronchiectasis.
Bronchiectasis involves permanent _______ of the bronchi.
Bronchiectasis involves permanent _______ of the bronchi.
Which of the following statements regarding bronchiectasis management is LEAST accurate?
Which of the following statements regarding bronchiectasis management is LEAST accurate?
Flashcards
Bronchiectasis
Bronchiectasis
Permanent dilation of the bronchi, leading to sputum collection and recurrent infections.
Causes of Bronchiectasis
Causes of Bronchiectasis
Idiopathic, pneumonia, whooping cough, tuberculosis, alpha-1-antitrypsin deficiency, connective tissue disorders, cystic fibrosis, yellow nail syndrome.
Yellow Nail Syndrome
Yellow Nail Syndrome
Yellow fingernails, bronchiectasis, and lymphoedema.
Symptoms of Bronchiectasis
Symptoms of Bronchiectasis
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Signs of Bronchiectasis
Signs of Bronchiectasis
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Sputum Culture in Bronchiectasis
Sputum Culture in Bronchiectasis
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Common Infective Organisms in Bronchiectasis
Common Infective Organisms in Bronchiectasis
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Chest X-Ray Findings in Bronchiectasis
Chest X-Ray Findings in Bronchiectasis
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High-Resolution CT (HRCT)
High-Resolution CT (HRCT)
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General Management of Bronchiectasis
General Management of Bronchiectasis
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Management of Infective Exacerbations in Bronchiectasis
Management of Infective Exacerbations in Bronchiectasis
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Antibiotic Duration for Exacerbations
Antibiotic Duration for Exacerbations
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Antibiotic for Pseudomonas Exacerbations
Antibiotic for Pseudomonas Exacerbations
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Bronchiectasis Pathophysiology
Bronchiectasis Pathophysiology
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Yellow Nail Syndrome Characteristics
Yellow Nail Syndrome Characteristics
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Tram-Track Opacities
Tram-Track Opacities
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Ring Shadows (Bronchiectasis)
Ring Shadows (Bronchiectasis)
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Respiratory Physiotherapy (Bronchiectasis)
Respiratory Physiotherapy (Bronchiectasis)
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Pulmonary Rehabilitation
Pulmonary Rehabilitation
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Azithromycin in Bronchiectasis
Azithromycin in Bronchiectasis
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Inhaled Colistin
Inhaled Colistin
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Bronchodilators in Bronchiectasis
Bronchodilators in Bronchiectasis
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Surgical Lung Resection
Surgical Lung Resection
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Lung Transplant
Lung Transplant
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Study Notes
Bronchiectasis Overview
- Bronchiectasis involves permanent dilation of the bronchi, the large airways that transport air to the lungs.
- This dilation leads to sputum collection, organism growth, chronic cough, continuous sputum production, and recurrent infections.
- Bronchiectasis results from damage to the airways, with potential causes including idiopathic factors, pneumonia, whooping cough (pertussis), tuberculosis, and Alpha-1-antitrypsin deficiency.
- Other causes include connective tissue disorders like rheumatoid arthritis, cystic fibrosis, and yellow nail syndrome.
Yellow Nail Syndrome
- Yellow nail syndrome is characterized by yellow fingernails, bronchiectasis, and lymphoedema.
Symptoms
- Key presenting symptoms of bronchiectasis include shortness of breath, chronic productive cough, recurrent chest infections, and weight loss.
Signs
- Signs include a sputum pot by the bedside, oxygen therapy (if needed), weight loss (cachexia), finger clubbing, and signs of cor pulmonale such as raised JVP and peripheral oedema.
- Other signs are scattered crackles throughout the chest that change or clear with coughing, plus scattered wheezes and squeaks.
Investigations
- Sputum culture helps identify colonizing and infective organisms, most commonly Haemophilus influenza and Pseudomonas aeruginosa.
- Chest x-ray findings include tram-track opacities (parallel markings of a side-view of the dilated airway) and ring shadows (dilated airways seen end-on).
- High-resolution CT (HRCT) is the test of choice for diagnosis.
Management
- General management includes vaccines (e.g., pneumococcal and influenza), respiratory physiotherapy, and pulmonary rehabilitation.
- Long-term antibiotics (e.g., azithromycin) are used for frequent exacerbations (3 or more per year).
- Inhaled colistin is specifically for Pseudomonas aeruginosa colonization.
- Long-acting bronchodilators may be considered for breathlessness, and long-term oxygen therapy for patients with reduced oxygen saturation.
- Surgical lung resection may be considered for specific areas of disease, and lung transplant is an option for end-stage disease.
Infective Exacerbations
- Sputum culture should be done before starting antibiotics.
- Extended courses of antibiotics are required, usually 7–14 days.
- Ciprofloxacin is the usual antibiotic choice for exacerbations caused by Pseudomonas aeruginosa.
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