Bronchiectasis

Question 1

Bronchiectasis: what is the underlying pathological process?

Answer 1

Permanent dilatation of the bronchi caused by chronic infection or inflammation.

Question 2

What is the classic symptom triad of bronchiectasis?

Answer 2

Persistent productive cough with large sputum volumes, dyspnoea, and haemoptysis.

Question 3

What type of sputum is typically produced in bronchiectasis?

Answer 3

Large volumes of thick, purulent sputum.

Question 4

Which clinical signs are commonly found on examination in bronchiectasis?

Answer 4

Coarse crackles, wheeze, and possible digital clubbing.

Question 5

What is the first step in managing a patient with suspected bronchiectasis?

Answer 5

Assess for and treat underlying causes such as immune deficiency.

Question 6

What is the purpose of physical training in bronchiectasis management?

Answer 6

Inspiratory muscle training improves lung function and has strong evidence in non-CF bronchiectasis.

Question 7

What is the role of postural drainage in bronchiectasis?

Answer 7

Helps clear airway secretions and reduces sputum burden.

Question 8

How are acute exacerbations of bronchiectasis treated?

Answer 8

With targeted antibiotics based on sputum microbiology.

Question 9

When are long-term rotating antibiotics used in bronchiectasis?

Answer 9

In patients with severe disease or frequent exacerbations.

Question 10

When might bronchodilators be used in bronchiectasis?

Answer 10

In selected patients to relieve airflow obstruction.

Question 11

Why are vaccinations important in bronchiectasis?

Answer 11

Immunisations such as influenza and pneumococcal vaccines reduce infection-triggered exacerbations.

Question 12

When is surgery considered in bronchiectasis?

Answer 12

For localised disease not controlled by medical therapy or causing recurrent infections.

Question 13

What is the most common organism isolated in bronchiectasis?

Answer 13

Haemophilus influenzae.

Question 14

Which organisms are also commonly isolated in bronchiectasis besides Haemophilus influenzae?

Answer 14

Pseudomonas aeruginosa, Klebsiella species, and Streptococcus pneumoniae.