Introduction
?? LLLF? ??, ????? ?? ??.
Etiology
Focal
Obstructon by foreign body or tumor
Diffuse
Tuberculosis, ABPA
Kartagener; inherited defect of the dynein arm, which is necessary for ciliary movement. Associated with chronic sinusitis, bronchiectasis, infertility, and situs inversus
- Congenital: Cystic fibrosis, Kartagener’s
- Chronic/prior infection: Aspergillosis, mycobacteria
- Rheumatic disease: Rheumatoid arthritis, Sjogren’s
- Immunodeficiency: Hypogammaglobulinemia
- Airway obstruction: Cancer
Epidemiology
Pathogenesis and pathology
Clinical manifestations
????, mucopurulenet sputum, ??? ?? ?? (except Bronchial a. ??).
Auscultation: Crackles, inspiratory rhonchi
Diagnosis
- Chest X-ray
- Cystic shadows, tram tracks, ring shadow
- Initial work-up
- PFTs: obstructive findings
- CF testing, sputum culture, immunoglobulin levels
- HRCT: ??? airway (vessel?? bronchus? 1.5?? ??)
Approach to the patient
Upper lobe: cystic fibrosis
Lower lobe: ?1-antitrypsin deficiency
Treatment
????? ?? ?? (H.influenza, P.aeruginosa) eg, Tazocin + Cipro
Acute exacerbation?? 7-10???
??: hydration, mucolytics, postural drainage
Antibiotic treatment
Bronchial hygiene
Anti-inflammatory therapy
Refractory cases
Complications
???? ? BAE
Hypoxemia with cor pulmonale and secondary (AA) amyloidosis.
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