Bronchiectasis

Question 1

Bronchiectasis definition

Answer 1

• abnormal destruction of bronchi
• due to destruction of elastic and muscular components of bronchial wall

Question 2

Bronchiectasis risk factors

Answer 2

• cystic fibrosis
• immunodeficiency
• previous infection
• congenital disorders of bronchi
• primary ciliary dyskinesia

Question 3

Bronchiectasis pathophysiology

Answer 3

• recurrent pulmonary infection causes bronchial damage
• especially Haem influenzae
• persistent airway inflammation causes bronchial wall oedema
• increased mucus leads to further damage
• may act as foci for further infection

Question 4

Bronchiectasis signs and symptoms

Answer 4

• persistent productive cough
• large volume of sputum
• dyspnoea
• haemoptysis
• clubbing
• coarse crackles and wheezing
• use bronchiectasis severity index (BSI)

Question 5

Bronchiectasis investigations

Answer 5

• sputum culture
• FBC
• CXR
• CT is best (ring in bud pattern, signet ring sign)
• spirometry
• 6 minute walk test
• pH testing

Question 6

Bronchiectasis management

Answer 6

• physical training
• exercise and pulmonary rehab
• airway clearance - hydration, chest physio, nebulised saline + mucolytics
• vaccination, treat infection
• if localised can consider surgery