BRONCHIETASIS

Question 0

What is bronchiectasis?

Answer 0

Irreversible airway dilation

Question 1

What are the causes of bronchiectasis?

Answer 1

Infection

• bacterial
• non tb mycobacterium
• HIV patients

Recurrent aspiration

Genetics

• CF
• alpha 1-antitripsin

RHEUMATOLOGICAL

• RA
• sjorgrens syndrome

Question 2

What is a general mechanism for bronchiectasis?

Answer 2

Infection/poor mucociliary clearance
Chronic inflammation
Damage, Dilation, loss of cartilage and SM

Question 3

S + S of bronchiectasis?

Answer 3

Persistent chest infection
Acute exacerbations of bronchiectasis usually characterized by
• Changes in sputum volume/purulence
• Fever may not be present
Bronchiectasis is a respiratory cause of clubbing

Question 4

Ix?

Answer 4

Look for infection via sputum MCS or BRONCHOALVEOLAR LAVAGE.

CT CHEST

Question 5

What are you looking for on CT CHEST?

Answer 5

Airway dilation -> tram tracks or signet ring sign
• Bronchial wall thickening in dilated airways
• Insippated secretions: tree in bud pattern
• Cysts emanating from bronchial wall

Question 6

Management?

Answer 6

If acute exacerbation - ABx
Enhance secretion clearance 
- hydration
- mucolytics
- chest physiotherapy
- hypertonic saline

Surgery
- resection
Transplant

Question 7

Complications?

Answer 7

Recurrent infections

Massive HAEMOPTYSIS