Bronchiectasis

Question 1

What is bronchiectasis?

Answer 1

Abnormal, permanent dilatation of the bronchi due to chronic inflammation and infection.

Question 2

What is the underlying pathological process?

Answer 2

Recurrent infection → chronic inflammation → airway wall damage → dilated bronchi.

Question 3

How is bronchiectasis classified by cause?

Answer 3

Congenital

Acquired

Question 4

Congenital causes of bronchiectasis?

Answer 4

Cystic fibrosis

Primary ciliary dyskinesia

Hypogammaglobulinaemia

Question 5

Acquired causes in children?

Answer 5

Pneumonia

Pulmonary TB

Inhaled foreign body

Question 6

Acquired causes in adults?

Answer 6

Suppurative pneumonia

Pulmonary TB

Allergic bronchopulmonary aspergillosis (ABPA)

Lung cancer

Question 7

Key respiratory symptoms of bronchiectasis?

Answer 7

Chronic cough

Copious sputum

Haemoptysis

Question 8

Systemic symptoms seen in bronchiectasis?

Answer 8

Weight loss

Anorexia

Lethargy

Question 9

Chest examination findings?

Answer 9

Coarse inspiratory crackles

Question 10

What chest pain symptom may occur?

Answer 10

Pleurisy

Question 11

First-line investigations for bronchiectasis?

Answer 11

Chest X-ray

Sputum cultures

Question 12

What is the gold standard investigation?

Answer 12

HRCT chest

Question 13

Typical HRCT findings?

Answer 13

Thickened, dilated airways

Question 14

What does the chest X-ray usually show?

Answer 14

Often normal or non-specific

Question 15

When is ciliary function testing indicated?

Answer 15

Only if ciliary dysfunction is suspected

Question 16

Broad management categories for bronchiectasis?

Answer 16

Conservative

Medical

Surgical

Question 17

Key conservative treatment?

Answer 17

Chest physiotherapy

Question 18

Medical treatments used in bronchiectasis?

Answer 18

Antibiotics

Bronchodilators

Steroids

Question 19

When is surgery considered?

Answer 19

Unilateral disease confined to a single lobe or segment

Question 20

Surgical option used?

Answer 20

Resection

Question 21

Most important investigation to confirm bronchiectasis?

Answer 21

HRCT

Question 22

Most characteristic symptom?

Answer 22

Copious purulent sputum

Question 23

Most important non-pharmacological therapy?

Answer 23

Chest physiotherapy