Resp 1

Question 1

What is bronchiectasis? Symptoms?

Answer 1

Permanent dilation of the bronchioles and inflammation of the walls, leading to purulent mucus production, wheeze, increased risk of infection

Question 2

Signs of bronchiectasis on examination and imaging

Answer 2

Auscultation - coarse inspiratory creps
Examination - clubbing
CXR - tram track lines
CT - signet ring dilation of bronchioles

Question 3

Causes of bronchiectasis

Answer 3

Young syndrome (ciliary dyskinesia, dextracardia and bronchiectasis)
Kartagener’s syndrome (obstructive azoospermia + bronchiectasis)
Cystic fibrosis

Post-infective
Obstructive - cancer

RA/IBD

Immune deficiency - Hypogammaglobulinemia

Question 4

Investigations for bronchiectasis

Answer 4

CXR
HRCT
Bronchoscopy if needed
Spirometry
Sputum sample + culture
Genetic screening / serum immunoglobulins, aspergillus antigen test

Question 5

Management of bronchiectasis

Answer 5

Respiratory physiotherapy / chest clearance for inspiratory muscle training
Mucolytics and bronchodilators
Empirical antibiotics
Immunisations
Surgery

Question 6

Most common pathogen associated with bronchiectasis?

Answer 6

H influenzae

Also: pseudomonas, klebsiella and strep

Question 7

Complications of bronchiectasis

Answer 7

Lobar collapse
Haemmorhage
T2RF

Pulmonary hypertension
Cachexia