LRTI - Bronchietasis

Question 1

What is bronchiectasis?

Answer 1

Dilated and damaged bronchi that makes patients more prone to other infections

Question 2

Causes?

Answer 2

Mainly idiopatic
Known to be:

Immotile cilla syndrome
Childhood infections
Hypo-gamma-globulinaemia
Allergic bronchopulmonary aspergillosis
Cystic fibrosis

Question 3

Symptoms?

Answer 3

Chronic cough - with purulent sputum wheeze, haemoptysis
Dyspnoea
Chest pain

Question 4

Signs?

Answer 4

Clubbing in very severe cases

Coarse inspiratory creps

Question 5

Investigations?

Answer 5

CT Thorax 
Sputum culture
Serum immunoglobulins
Total IgE and aspergillus precipitins
CF genotyping

Question 6

What is seen in a CT thorax?

Answer 6

Airway dilation

Compare both sides

Question 7

Why is a serum immunoglobulin done?

Answer 7

To check for immunoglobulin G deficiency for Hypo-gamma-globulinaemia

Absense of immunoglobulin G makes infections very common

Question 8

Why is a Total IgE and aspergillus precipitins test done?

Answer 8

Looking for allergic bronchopulmonary aspergillosis (ABPA)

Question 9

Treatment for bronchiectasis?

Answer 9

Bronchodilators
Chest physiotherapy
Treat infections with antibiotics

Question 10

Why give bronchodilators when airways are dilated?

Answer 10

Only useful if patient also has asthma/COPD