bronchiectasis

Question 1

What is bronchiectasis?

Answer 1

Permanent abnormal dilation of one or more lungs of bronchi
Extra mucus secreted - pools in dilated airways
More prone to infection

Question 2

What is the pathology of bronchiectasis?

Viscous Cycle

Answer 2

Impaired mucocillary clearance
Accumulation of secretions
Bacterial infection
Mucus production/ impaired ciliary response
Inflamation
Tissue damage
Produces dilated bronchi, impaired cilia, mucus production

Question 3

What are the causes of bronchiectasis?

Answer 3

Idiopathic
Childhood infection
Cystic fibrosis
Immunodeficiency 
Cilia dysfunction
ABPA - Allergic BronchoPulmonary Aspergillosis
Inflammatory conditions
Aspiration/ Obstruction

Question 4

What are the clinical features of bronchiectasis?

Answer 4

All cough and chronic sputum production
75% dsypnoae & wheeze
50% chest pain
1/3 have signs of chronic sinusitis & nasal polyps - nasal growth
Exacerbations - acute means increased symptoms
Haemoptysis

Question 5

How is bronchiectasis diagnosed?

Answer 5

Chest x-ray
HRCT - High Resolution Computerised Tomography
Blood & Sputum Microbiology
Pulmonary Function Tests

Question 6

What are the types of bronchiectasis?

Answer 6

Saccular - in large bronchi, ballon like
Cylindrical - medium sized bronchi, symmetrically dilated
Varicose - constrictions & dilations deform bronchi

Question 7

How is bronchiectasis managed?

Answer 7

Physio
Antibiotics
Bronchodilators
Steroids
Nasal spray 
Flu & pneumococcal vaccines
Surgery