Bronchiectasis

Question 1

Define, RF and causes of bronchiectasis

Answer 1

Chronic inflam of the airways causing permenant expansion of the airways

Main responsibles: Pseudomonas, staph aureus, H influenzae, strep pneumoniae

Can be come from congenital: CF, Youngs, Primary cilliary dyskinesaie

Post infection (pneumoniae, TB, petussis, HIV)

Or other: Bronchial obstruct (tumor/Foreign object), allergy aspergilliousus, RA, UC, idiopathic

RISK FACTORS: smoking, fam history of CF/AID

Question 2

Sx and Signs, and Ix of bronchiectasis

Answer 2

Persistant productive cough with LOTS of sputum production (usually darker green)

SOB, Wheeze, heamoptosis/Blood tinged sputum (IMPORTANT), weight loss

exarcerbation- darker sputum/more, cough, fatigue/fever

On exam- wheeze and crackles
CLUBBING

signs of the cause- systemic illness, RF, other

Ix
FBC- show infection, high eosinophil-think APBP

classic Tramlines on Xray-very non specific

sputum culture useful for DX-25% are Pseudomonas

GOLD STANDARD- CT

Question 3

Management of bronchiectasis

Answer 3

Conservative-
Sputum management- chest physio, coughing techniques
Diet

Medical-
Abx for exacerbation-based on sensitivities
Long term Abx if reccurent (3 or more)
Immunisation-
Mucolytics, dilators, inhaled steroids to discuss-esp with COPD, asthma

rarely- surgery if localised disease