8. Chronic resp. diseases

Question 1

what does this CT scan show

Answer 1

bronchiectasis:

• bronchial dilatation (bigger than adjacent blood vessel)
• bronchial wall thickening

Question 2

what is bronchiectasis and name 3 main causes

Answer 2

Chronic dilatation of one or more bronchi, which therefore exhibit poor mucus clearance, predisposing to infection. Causes inc.:

1. Genetic mucociliary clearance defects, e.g. CF
2. Post-infective, e.g. TB, whooping cough
3. Immune deficiency - hypogammaglobulinaemia

Question 3

what are the main symptoms of bronchiectasis

Answer 3

Very common:

1. chronic cough
2. sputum production

Common:

3. SOB on exertion
4. intermittent haemoptysis
5. chest pain
6. fatigue

Question 4

describe the management of bronchiectasis

Answer 4

1. treat underlying cause
2. physiotherapy - airway clearance
3. antibiotics
4. supportive - eg flu vaccine, bronchodilators if required

Question 5

what is a bronchiectasis exacerbation

Answer 5

deterioration in 3 or more key symptoms for at least 48 hrs

• cough
• sputum volume and/or consistency
• sputum purulence
• breathlessness and/or exercise tolerance
• haemoptysis
• fatigue