Bronchiectasis

Question 1

Definition of bronchiectasis

Answer 1

The permanent abnormal dilation of the bronchi within one or both lungs. Extra mucus pools within these areas of dilation. This leaves the individual more prone to infection. It has similar symptoms to COPD but does not always show as obstructive so cannot be classified as COPS

Question 2

Pathology of bronchiectasis

Answer 2

IT IS A CYCLE
1- Impaired mucociliary performance leads to the accumulation of secretions
2- the accumulation of secretions leads to bacterial infections
3- Bacterial infections to lead increased mucus, inflammatory response and reduced ciliary performance
4- excessive inflammatory response leads to tissue damage
5- tissue damage leads to bronchi dilation, loss of ciliated epithelium, and impaired mucociliary performance

Question 3

Possible causes of bronchiectasis (7)

Answer 3

• idiopathic
• infection, most common in childhood
• CF
• Immunodeficient
• ciliary dysfunction
• inflammatory disorder
• obstruction

Question 4

3 types of bronchiectasis

Answer 4

1: saccular: large bronchi dilated like a balloon
2: cylindrical: medium bronchi dilated in a symmetrical fashion
3: varicose: dilations and constrictions deform the bronchi

Question 5

Clinical features of bronchiectasis

Answer 5

• persistent cough/sputum
• wheeze
• chest pain
• chronic sinusitis
• recurrent exacerbations
• haemoptysis

Question 6

Symptoms of acute exacerbation (6)

Answer 6

• increase cough
• increased sputum
• increased temperature >38
• increased wheeze/changes to breath sounds
• XRAY consistent with changes
• general malaise