Bronchiectasis

Question 1

What is Bronchiectasis?

Answer 1

Permanent dilation of the airways secondary to chronic infection or inflammation.

Question 2

Give 7 causes of Bronchiectasis.

Answer 2

1. Post Infective (e.g. TB, Measles, Pertussis, Pneumonia).
2. CF.
3. Obstruction e.g. Cancer, Foreign Body.
4. Immune Deficiency (Selective IgA, Hypogammaglobulinaemia).
5. ABPA - Allergic Bronchopulmonary Aspergillosis.
6. Ciliary Dyskinetic Syndromes e.g. Kartagener’s, Young’s.
7. Yellow Nail Syndrome.

Question 3

Which pathogens most commonly affect Bronchiectasis patients? (5)

Answer 3

1. H. influenza.
2. P. aeruginosa.
3. S. pneumoniae.
4. S. aureus.
5. Klebsiella.

Question 4

Clinical Features of Bronchiectasis (6).

Answer 4

1. Productive Cough - Lots of Purulent Sputum.
2. Haemoptysis.
3. Finger Clubbing.
4. Coarse Inspiratory Crepitations.
5. Dyspnoea.
6. Wheeze.

Question 5

Investigations of Bronchiectasis (5).

Answer 5

1. Spirometry : Obstructive.
2. Sputum Culture.
3. CXR : Thickened Bronchial Walls and Cystic Appearance - Tramline and Ring Shadows.
4. High-Resolution CT : Best.
5. Bronchoscopy.

Question 6

Conservative Management of Bronchiectasis.

Answer 6

1. Patient Education.
2. Chest Physiotherapy - Postural Drainage 2x Daily.
3. Smoking Cessation.
4. Physical Training - Inspiratory Muscle Training.

Question 7

Medical Management of Bronchiectasis.

Answer 7

1. Antibiotics.
2. Bronchodilators.
3. Corticosteroids - ABPA.
4. Carbocysteine - Mucolytic.

Question 8

Surgical Management of Bronchiectasis.

Answer 8

1. Surgical Excision of Localised Area of Disease.

2. Lung Transplant.