Bronchiectasis

Question 1

What is bronchiectasis?

Answer 1

permanent dilation of bronchioles (+ excessive mucus in them)
Usually affects lower lobes

Question 2

What Sx does it produce?

Answer 2

Productive cough with lots of sputum + dyspnoea

Question 3

Rf?

Answer 3

MC = post infection (TB, Pneumonia)
Also CF, HIV, ABPA

Question 4

Pathology?

Answer 4

Irreversible dilation, lots of cilia + mucus hyper secretion
increased risk of infection as decreased mucociliary clearance

Question 5

Dx?

Answer 5

Chest x ray
GS = HRCT - Dilated thickened bronchi (signet ring sign) + cysts at end of bronchioles
Spirometry = Obstructive ; FEV1:FVC <0.7
Sputum culture (check infection) = Organisms:
H.influenzae
S. pneumoniae
P. auriginosa

Question 6

Tx for
H.influenzae
S. pneumoniae
P. auriginosa

Answer 6

H.influenzae
S. pneumoniae
Amoxicillin

P. auriginosa
PIP + TA20

Question 7

Tx for bronchiectasis?

Answer 7

Conservative = chest physio + stop smoking

Drug = bronchodilators

Consider Abx if infection