Bronciectasis

Question 1

What is the gold standard for diagnosing bronchiectasis?

Answer 1

High resolution CT scan

• signet ring sign
• airway dilatation
• bronchial wall thickening
• bronchial wall cysts

Question 2

What are come common causes of bronchiectasis?

Answer 2

Post TB or whooping cough 
Hypogammaglobulinaemia 
Genetic 
- cystic fibrosis
- primary ciliary dyskinesia 
- Youngs syndrome 
- Kartageners syndrome 
Obstruction  
- foreign body 
- tumour
Allergic bronchopulmonary aspergillosis 
RA

Question 3

Give some common organisms that occur in people with bronchiectasis

Answer 3

Haemophilus influenzae
Pseudomonas aeruginosa
Moraxella catarrhalis
Aspergillus and candida fungi

Question 4

What is the management for someone with bronciectasis?

Answer 4

Treat the underlying cause
Chest physiotherapy, to help with mucus clearance
Abx guided by sputum cultures
Supportive treatment
- flu vaccine
- bronchodilators
Pulmonary rehabilitation if MRC dyspnoea score is >/= 3

Question 5

What are the clinical features of bronciectasis?

Answer 5

Chronic productive cough (thigh green sputum in severe cases)
Recurrent chest infections
Haemoptysis
Dyspnoea
Wheeze
Clubbing
Coarse crackles over the effected area (bases generally)

Question 6

Give some complications of bronchiectasis

Answer 6

Haemoptysis 
Pneumonia 
Empyema 
Metastatic cerebral abcess 
Pneumothorax
Respiratory failure

Question 7

Define bronciectasis

Answer 7

Chronic dilatation of one or more bronchi (central and medium sized airways)

• Have poor mucus clearance
• Predisposition to recurrent/chronic bacterial infection