BRONCHIECTASIS

Question 1

WHAT IS BRONCHIECTASIS?

Answer 1

Chronic dilatation of one or more bronchi. The bronchi exhibit poor mucus clearance, leading to build up of mucus and there is predisposition to recurrent or chronic bacterial infection

Question 2

WHAT IS THE GOLD STANDARD TEST FOR BRONCHIECTASIS?

Answer 2

High resolution CT

Question 3

WHAT ARE THE CAUSES OF BRONCHIECTASIS?

Answer 3

1) Genetic/ mucociliary clearance defects- CF, primary ciliary dyskinesia
2) Obstruction - foreign body, tumour
3) Rheumatoid arthritis

Question 4

WHAT ARE THE SYMPTOMS OF BRONCHIECTASIS?

Answer 4

1) Persistent cough
2) Purulent sputum
3) Intermittent haemoptysis
4) dyspnoea
5) fever

Question 5

WHAT ARE THE SIGNS OF BRONCHIECTASIS?

Answer 5

1) finger clubbing
2) coarse inspiratory crepitations
3) wheeze

Question 6

WHAT ARE THE INVESTIGATIONS FOR BRONCHIECTASIS?

Answer 6

1) CXR - exclude other pathology and help confirm diagnosis
2) Sputum culture - identify colonising pathogens
3) High-resolution computed tomography (HRCT) - recommended for all patients and show bronchi dilation
4) Post bronchodilator spirometry - spirometry shows obstructive pattern
5) Exclude underlying causes - CF sweat test, test ciliary function

Question 7

WHAT IS THE MANAGEMENT OF BRONCHIECTASIS?

Answer 7

1) Pulmonary rehabilitation
2) Airway clearance therapy- chest physiotherapy
3) Inhaled bronchodilators
4) Mucolytic