Bronchiectasis

Question 1

Bronchiectasis: definition

Answer 1

Bronchiectasis is a permanent dilatation and thickening of the airways characterised by chronic cough, excessive sputum production, bacterial colonisation, and recurrent acute infections

Question 2

Pathophysiology

Answer 2

Caused by chronic inflammation of the airways, often 2y to lung infections (especially in childhood), cystic fibrosis and immunodeficiency

Airways are inflamed and collapse easily
The airway impairment and reduced secretion drainage leads to accumulation of mucus in the lungs.

The mucus collects bacteria - so LTRIs are more likely

Obstruction causes a focal form, otherwise its diffuse

Question 3

Symptoms

Answer 3

Purulent sputum
Dyspnoea
Chest pain
Haemoptysis

Question 4

Signs

Answer 4

Coarse crackles
Rhonchi (snore like sounds)
Wheeze 1/3
Clubbing

Question 5

Investigations

Answer 5

HRCT (bronchial wall dilation, with wall thickening)
CXR - baseline and exclude other causes
Sputum culture
(if under 40 sweat test to check for cystic fibrosis)

Question 6

Management

Answer 6

Treat any underlying causes
Flu vaccine
Physiotherapy - airway clearance technique
Antibiotics if infection