Bronchieactasis

Question 1

What is the best diagnostic for Bronchieactasis?

Answer 1

High resolution CT, showing tram-track sign, signet ring sign and string of pearls

Question 2

Which allergy is known to cause Bronchieactasis?

Answer 2

Allergic bronchopulmonary aspergillosis because chronic inflammation from this can cause Bronchieactasis

Aspergillus precipitins/fumigatus IgE test or skin prick test

Patients withbronchiectasissecondary to allergic bronchopulmonary aspergillosis (ABPA) may be treated withPrednisolone

Question 3

Wha is the most common cause of Bronchieactasis?

Answer 3

Severe lower respiratory tract infection like pneumonia, TB or influenza

Question 4

What are the symptoms of bronchieactasis?

Answer 4

Productive cough lasting at least 8 weeks
Copious production of purulent sputum
Dyspnoea
Haemoptysis
Chest pain
Fatigue
Weight loss

Question 5

What are the examination findings for bronchieactasis?

Answer 5

Coarse INSPIRATORY crackles on auscultation
Wheeze
Rhonchi (snoring sounds caused by secretions in the larger airways)
Finger clubbing

Question 6

What is the long term antibiotic prophylaxis given?

Answer 6

More than 3 exacerbations a year with nebulised colony in for pseudomonas aeruginosa carriers

Question 7

What is the initial management of bronchieactasis? c

Answer 7

Chest physiotherapiy

Question 8

What is used to manage allergic bronchopneumonia ray aspergillosis?

Answer 8

Corticosteroids

Question 9

What does allergic bronchopulmonary aspergillosis result from?

Answer 9

An allergy to Aspergillus spores

Question 10

What is often included in the patient history for exam questions regarding allergic bronchopulmonary aspergillosis?

Answer 10

Bronchiectasis and eosinophilia

Question 11

What are common features of allergic bronchopulmonary aspergillosis?

Answer 11

Bronchoconstriction, wheeze, cough, dyspnoea

Question 12

What previous label might patients with allergic bronchopulmonary aspergillosis have?

Answer 12

Asthma

Question 13

What type of bronchiectasis is associated with allergic bronchopulmonary aspergillosis?

Answer 13

Proximal bronchiectasis

Question 14

What laboratory finding is indicative of allergic bronchopulmonary aspergillosis?

Answer 14

Eosinophilia

Question 15

What type of changes might be seen on a chest X-ray (CXR) for allergic bronchopulmonary aspergillosis?

Answer 15

Flitting CXR changes

Question 16

What test is positive in allergic bronchopulmonary aspergillosis that indicates an allergy to Aspergillus?

Answer 16

Positive radioallergosorbent (RAST) test

Question 17

What type of precipitins may be found in allergic bronchopulmonary aspergillosis?

Answer 17

Positive IgG precipitins

Question 18

How does the positivity of IgG precipitins in allergic bronchopulmonary aspergillosis compare to that in aspergilloma?

Answer 18

Not as positive as in aspergilloma

Question 19

What is a common immunoglobulin level that is raised in allergic bronchopulmonary aspergillosis?

Answer 19

Raised IgE

Question 20

What is the first-line management for allergic bronchopulmonary aspergillosis?

Answer 20

Oral glucocorticoids

Question 21

What is sometimes introduced as a second-line agent in the management of allergic bronchopulmonary aspergillosis?

Answer 21

Itraconazole

Question 22

Which physical sign is seen in Bronchieactasis?

Answer 22

Clubbing

Question 23

Which organisms are associated with Bronchieactasis?

Answer 23

Haemophilius influenzae is most common

-> Pseudomonas aeruginosa
Klebsiella spp.
Streptococcus pneumoniae

Question 24

What is the treatment of Bronchieactasis in the long term?

Answer 24

Postural drainage and inspiratory muscle training to aid mucus clearance

Question 26

What is an indication for surgery in Bronchieactasis

Answer 26

uncontrollable haemoptysis and localised disease to one lobe

Question 27

What history is Bronchieactasis linked to.

Answer 27

Chronic pulmoanry damage during childhood, like recurrent pneumonia

Question 28

What PMHx is linked to Bronchieactasis?

Answer 28

Rheumatoid arthritis