Bronchiectasis

Question 1

Physiological abnormalities

Answer 1

Bronchi are dilated, inflamed and easily collapsible–>airflow obstruction and impaired clearance of secretions

Question 2

Prior events

Answer 2

Prior infections, e.g. Bordetella pertussis, measles and bacterial pneumonia
Immunodeficiency
Acquired causes e.g tuberculosis, connective tissue diseases, allergic bronchopulmonary aspergillosis and foreign body aspiration
Congenital causes- ciliary dyskinesia including kartagener syndrome, alpha-1 antitrypsin deficiency

Question 3

Symptoms

Answer 3

Dyspnoea
Chronic sputum production- green/yellow
Repeated chest infections
Haliotosis- bad breath

Question 4

Signs

Answer 4

Coarse credits toons
Hypoxaemia
Hypercapnia

Question 5

Abnormal test results

Answer 5

CT- signet ring
Obstructive pattern on spirometer
Low O2 high CO2

Question 6

What are the structural abnormalities?

Answer 6

Localised, irreversible dilation of part of the bronchial tree
Form of obstructive lung disease

Question 7

Medical/surgical intervention

Answer 7

Controlling infections and bronchial secretions
relieving airway obstruction
Small no. cases bronchiectasis surgery
Nebulised antibiotics- colomycin, tobramycin and axtreonam
Maintain body weight

Question 8

Primary and secondary prevention

Answer 8

Children should be immunised; measles, pertussiss

adult vaccination- pneumonia and influenza