Bronchiectasis

Question 1

What is bronchiectasis?

Answer 1

Permanent dilation of the bronchi and bronchioles due to chronic infection

Question 2

What are the 4 main organisms that cause bronchiectasis, and which of these is the commonest?

Answer 2

• Haemophilus Influenzae (commonest)
• Pseudomonas aeruginosa
• Streptococcus Pneumoniae
• Staphylococcus aureus

Question 3

Name 2 causes of bronchiectasis

Answer 3

• Post-Infection i.e. tuberculosis, HIV, measles, pneumonia, pertussis
• Obstruction by foreign body or tumour
• Allergic Bronchopulmonary aspergillosis (ABPA)
• Congenital i.e. cystic fibrosis, Kartagener’s syndrome, primary ciliary dyskinesia Young syndrome
• Idiopathic

Question 4

1) Name 2 symptoms
2) Name 2 signs

Answer 4

1) Productive cough, purulent sputum, haemoptysis, shortness of breath
2) Finger clubbing, coarse inspiratory crepitations, dyspnoea, wheeze

Question 5

Name a potential complication of bronchiectasis

Answer 5

• Pneumonia
• Pleural effusion
• Pneumothorax

Question 6

1) What would a spirometry show in a patient with bronchiectasis?
2) What is the best diagnostic investigation for bronchiectasis?
3) Name another important investigation

Answer 6

1) Obstructive pattern of disease
2) High resolution CT (tram track and signet ring signs)
3) Chest x-ray, sputum culture, bronchoscopy

Question 7

Name an aspect of the conservative management of bronchiectasis

Answer 7

• Patient education
• Support Group
• Chest physiotherapy – postural drainage at least twice daily to aid mucous drainage
• Smoking Cessation

Question 8

In the medical management of bronchiectasis, what are the 4 main medications that may be used?

Answer 8

• Antibiotics
• Bronchodilators for symptoms of dyspnoea and wheeze such as in COPD, ABPA, asthma
• Corticosteroids
• Carbocysteine (mucinolytic)

Question 9

Which of the 4 medications that may be used in bronchiectasis management is used in ABPA treatment?

Answer 9

Corticosteroids (prednisolone)