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Bronchiectasis
- Irreversible thickening of the bronchial tubes caused by destruction of the tissue
- Causes
- Cystic fibrosis causes 50% of cases
- Recurrent infection
- Autoimmune diease
- Recurrent pneumonia is a serious complication
Clinical Presentation
- Chronic productive cough
- Hemoptysis
- Pleuritic chest pain
- Dyspnea
- Wheezing
Labs, Studies and Physical Exam Findings
- Bibasilar crackles
- Clubbing Sputum
- Gram stain and culture
- Pulminary function test
- Reduced FEV1
- Chest X-ray
- Tram tracks or ring like markings – dilated thickened bronchi
- Atelectasis
- CT confirms diagnosis and gives detailed view of the extent of disease
Treatment
- Prophylactic antibiotics may be necessary
- Bronchodilators
- Surgical resection if disease is found all in one area
Cystic fibrosis
- Pancreatic insufficiency is a major part of the disease
- Scarring and cyst formation in the pancreas
- Autosomal recessive
- exocrine glands become clogged
Clinical Presentation
- Chronic lung issues
- Cough
- Hemoptysis
- Decreased exercise tolerance
- Steatorrhea
- Diarrhea
- Abdominal pain
- Sinusitis
- Salty tasting skin
- Poor growth and weight gain
- Infant with bowel obstruction
- Male infertility
Labs, Studies and Physical Exam Findings
- Clubbing
- Hyperresonance to percussion
- Apical crackles
- Arterial blood gas will show hypoxemia
- Pulmonary function testing
- Total lung capacity is decreased
- FEV1 is decreased
- Chest X-ray
- Hyperinflation
- Peribronchial cuffing
- Atelectasis
- CT
- Chloride sweat test shows elevated sodium chloride levels
- Pancraetic function test
Treatment
- Chest percussion
- Directed cough
- Flutter valve breathing device
- Inhaled beta 2 agonists
- Inhaled hypertonic saline
- Antibiotics
<< Click here to get 40 Pulmonology questions straight from my book The Final Step >>