Bronchiectasis

Question 1

Bronchiectasis pathology

Answer 1

Chronic inflammation of bronchi and bronchioles resulting in permanent dilatation + thinning of airways

Question 2

Bronchiectasis causes

Answer 2

CF
Primary ciliary dyskinesia

Measles, pertussis
Bronchiolitis, Pneumonia
TB, HIV

RA
UC
ABPA
Bronchial obstruction

Question 3

Bronchiectasis signs + symptoms

Answer 3

Persistent cough
Copious purulent sputum ± haemoptysis

Clubbing
Wheeze
Inspiratory crepitations

Question 4

Bronchiectasis complications

Answer 4

Pneumonia
Pleural effusion
Pneumothorax
Cerebral abscess

Question 5

Bronchiectasis tests

Answer 5

Sputum culture
CXR shows thickened bronchial walls (tramline + ring shadows)
Spirometry shows obstructive pattern
Bronchoscopy for obstruction/ obtain culture samples

Question 6

Bronchiectasis management

Answer 6

Airway clearance + mucolytics (chest physio)
Bronchodilators if asthma

Abx for bacterial sensitivities
Pseudomonas long-term abx (maybe nebulised) if ≥3 per year
Pred ± itraconazole for ABPA

Surgery for localised/ severe haemoptysis