Bronchiectasis

Question 1

Define Bronchiectasis

Answer 1

Chronic dilatation of bronchi, poor mucus clearance and there is a predisposition to recurrent or chronic bacterial infection.

Question 2

What is the diagnostic test for Bronchiectasis?

Answer 2

High resolution CT - Will see dilatation and thickening of the bronchi - will be thicker than surrounding blood vessels

Question 3

What are some of the causes of Bronchiectasis?

Answer 3

Post infective - Whooping cough, TB
Immune deficiency - Hypogammaglobulinaemia
Genetic/Mucociliary clearance defects - CF, Primary ciliary dyskinesia, Young’s syndrome, Kartagener syndrome
Obstruction - Foreign body, tumour
Toxic insult - Inhalation, Gastric aspiration
ABPA
Secondary immune deficiency - HIV, Malignancy

Question 4

What diseases are associated with Bronchiectasis?

Answer 4

Inflammatory bowel disease
Yellow syndrome (Primary lymphoedema associated with yellow nails and pleural effusion due to lymphatic hypoplasia)

Question 5

What are the common causative organisms of Bronchiectasis?

Answer 5

Haemophilus Influenzae
Pseudomonas Aeruginosa
Fungi - Aspergillus, candida
Staphylococcus Aureus (Especially CF)

Question 6

What is the Signet ring sign?

Answer 6

On CT

Dilated & Thickened bronchioles that are bigger than the associated blood vessels

Question 7

How can you manage a patient with Bronchiectasis?

Answer 7

Treat the underlying cause
Physiotherapy to help with mucus clearance
Supportive eg vaccinations, bronchodilators if needed
Pulmonary rehab if MRC dyspnoea score above 3
Antibiotics if acute exacerbation

Question 8

What is Young’s syndrome?

Answer 8

Bronchiectasis
Sinusitis
Reeduced fertility

Question 9

What is Kartagener syndrome?

Answer 9

Bronchiectasis
Sinusitis
Situs Inversus