Bronchiectasis

Question 1

Define Bronchiectasis

Answer 1

The permanent abnormal dilation in one or more of the lungs bronchi
Extra mucous is secreted and pools in the areas of the airways that are dilated making person prone to infection

Question 2

Describe the pathology of bronchiectasis

Answer 2

Impaired mucociliary clearance leads to accumulation of secretions
» infection by bacteria
» increased mucous production, impaired ciliary performance, increased inflammatory response
» Tissue damage
» Dilated bronchi included loss of ciliated epithelium and impaired clearance
VICOUS CYCLE

Question 3

List 7 causes of bronchiectasis

Answer 3

Idiopathic
Infection
CF
Immunodeficiency
Ciliary dysfunction
ABGA (a fungal infection)
Inflammatory conditions
Aspiration/ obstruction

Question 4

List five clinical features of bronchiectasis

Answer 4

Cough
Chronic sputum production
Dyspnoea and wheeze (75%)
Chest pain (50%)
Chronic sinusitis and polyps (1/3)
Haemoptysis (50%)

Question 5

How is bronchiectasis diagnosed?

Answer 5

CXR
High resolution CT
Bloods and sputum microbiology
PFT
Colonising vs. isolating bacteria

Question 6

Describe the three types of bronchiectasis

Answer 6

Saccular - large bronchi only, become big and balloon like
Cylindrical - medium sized bronchi, symmetrically dilated
Varicose - constrictions and dilations that deform the bronchi

Question 7

Give 5 ways bronchiectasis is managed

Answer 7

Physio
IV/oral/nebulized antibiotics
Bronchodilators
Steroids
Nasal sprays
Flu/ pneumonia vaccines
Surgery - transplant in rare cases