Bronchiectasis

Question 1

Definition

Answer 1

Permanent dilation of the bronchi resulting in mucus build up and recurrent infection

Question 2

Causes

Answer 2

alpha1 antitrypsin deficiency
CF
Asthma, COPD
Sarcoidosis
TB
Primary ciliary dyskinesia
Yellow nail syndrome
Pneumonia
Whooping cough
UC, Crohn’s
Idiopathic
CT disorders (RA)
Immune system deficiency

Question 3

Symptoms

Answer 3

Chronic productive cough
Weight loss
SOB
May have chest pain and haemoptysis
Recurrent chest infections

Question 4

Signs on examination

Answer 4

Scattered crackles, wheeze and squeaks
Cachexia
May have raised JVP, peripheral oedema (cor pulmonale)
Finger clubbing

Question 5

Investigations

Answer 5

CXR - tram tracks and ring shadows
Sputum culture
High res. CT scan

Question 6

Common organism

Answer 6

Pseudomonas aeruginosa
H. influenza

Question 7

Treatment

Answer 7

Pneumo and flu vaccine
Prophylactic Abx if >3 exacerbations/year
Inhaled colistin for pseudo
Exacerbation: Ciprofloxacin for 7-14 days for pseudo