Bronchiectasis

Question 1

Bronchiectasis

Answer 1

Destruction & dilatation of proximal & medium sized bronchi > 2mm

Question 2

Dry Bronchiectasis seen in

Answer 2

tb

Question 3

Area involved in Bronchiectasis

Answer 3

Lower lobes
Right middle lobe
Lingula

Question 4

Allergic Bronchopulmonary Aspergilloma

Answer 4

Hypersensitivity reaction against Aspergillus fumigatus
IgE elevated
Sputum : Fungal hyphae
HRCT : Central bronchiectasis
Tx : steroid

Question 5

Colonisation of airway in cystic fibrosis by

Answer 5

P. aeruginosa

Question 6

Kartagener syndrome triad

Answer 6

Recurrent sinusitis
Bronchiectasis
Sinus inversus

Question 7

Kartagener syndrome vs cystic fibrosis

Answer 7

in KS : Male fertility
in CS : both Female & Male fertility

Question 8

Upper lobe Bronchiectasis

Answer 8

Cystic fibrosis
TB
Post radiation fibrosis
ABPA

Question 9

Middle lobe Bronchiectasis

Answer 9

Non TB mycobacterium mycobacteria
Kartagener Syndrome
William Campbell syndrome

Question 10

Lower lobe Bronchiectasis

Answer 10

Scleroderma
Hypo gammaglobulinemia
ILD-IPF

Question 11

-Productive cough
-Bronchorrhea, increase purulence with exacerbation
-Dyspnea on exertion
-Crept > ronchi
-CLUBBING
-weakness, weight loss
-cor pulmonale
cynosis -+

Answer 11

Bronchiectasis

Question 12

-Smoker
-bronchorrhea
-repeated exacerbation
-ronchi
NO CLUBBING
-BLUE BLOATER

Answer 12

Chronic Bronchitis

Question 13

Ix of Bronchiectasis

Answer 13

X-ray : Normal / Tram track appearance
IOC : HRCT - Tram track appearance
- Signet Ring ( d of airway > 1.5* Blood vessel)
Pulmonary Function test : obstructive
FEV1/FVC < 0.7
no improvement with bronchodilator
Sputum culture : DITTRICH PLUGS
ABLS - M/E - fungal hyphae
Quantitative Ig level
Genetic testing : Alpha 1 AT quantitative assay
Pilocarpine iontophoresis for cystic fibrosis
Nasal / lung biopsy / video microscopic analysis : Kartagener syndrome

Question 14

Tx of Bronchiectasis

Answer 14

-Non-TB Mycobacterium : Macrolide + Rifampicin + Ethambutol
-Mucolytic for purulent bronchorrhea : DORNase / DNase CF
I-nspissated secretion : 3% saline nebulization with bronchodilator
-Percussion device : dislodgment of mucus
-Romsons Respirometer
-Vaccines
-Gamma globulins in hypogammaglobulinemia
-ABPA : Steroid or Itraconazole
-Antibiotics : Ciprofloxacin BD - 2 week on, 2 week off
Macrolide : OD
Tobramycin nebulization in Cystic Fibrosis