Bronchiectasis

Question 1

What is bronchiectasis?

Answer 1

Permanent dilation of the airways caused by chronic inflammation and inability to clear secretions.

Question 2

Pathophysiology

Answer 2

This is dependent on the cause. Initially there is infection in the small distal airways that results in inflammation and the release of inflammatory mediators. This impairs ciliary action, allows for bacterial proliferation and tissue damage > causes bronchial dilation.

Question 3

What are the congenital causes of bronchiectasis?

Answer 3

Cystic fibrosis.
Young’s syndrome.
Kartagener’s syndrome.

Question 4

What are the causes of acquired bronchiectasis?

Answer 4

Tumours.
Rheumatoid arthritis.
IBS.

Question 5

Complication?

Answer 5

Massive haemoptysis: medical emergency!!

Question 6

Causative organsims?

Answer 6

Streptococcus pneumoniae.
Haemophilus influenzae.
Staphylococcus aureus.
Pseudomonas aeruginosa: common in CF patients.

Question 7

Treatment (ABCDS).

Answer 7

Antibiotics.
Bronchodilators.
Corticosteroids.
postural Drainage.
Surgery (if indicated).

Question 8

Symptoms?

Answer 8

Purulent sputum.
Persistent cough.
Fever.

Question 9

Signs?

Answer 9

Clubbing.
Crepitations.
Coarse inspiratory crackles.

Question 10

Investigations.

Answer 10

Bloods.
CXR.
Sputum culture and sensitivity.
Aspergillus screen if cause suspected.