Bronchiectasis

Question 1

What is bronchiectasis?

Answer 1

Bronchiectasis is a long-term condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.

Question 2

How do you diagnose bronchiectasis?

Answer 2

Gold standard test is High resolution CT Chest scan

Question 3

What type of CT is useful in diagnosing bronchiectasis?

Answer 3

High resolution CT scan

Question 4

What blood tests do we consider when diagnosing bronchiectasis?

Answer 4

Routine blood tests: FBC, UEs, LFTs, CRP

Advanced test: Immunoglobulins to look for ant CVID, Serum total igE, Aspergilus IgE, Aspergillus igG

Consider serum functional antibody levels to strep pnuemonia, and H influenza

Question 5

What should we always send to the labs when someone is having an exacerbation of their bronchiectasis?

Answer 5

Sputum, Sputum, and Sputum!

Question 6

How long do we give antibiotics for in bronchiectasis?

Answer 6

10 - 14 days

Question 7

When can we consider nebulised antibiotics therapy in a patient with bronchiectasis?

Answer 7

Those who need eradication of pseudomonas

Those with colonised pseudomonas with recurrent infections

Question 8

What other treatments are useful in bronchiectasis?

Answer 8

Airway clearance techniques - By respiratory physiotherapists

Prophylactic antibiotics

Pulmonary rehabilitation

Consider:
- LTOT
- Surgery
- Transplantation
- End of Life Support

Question 9

When can we consider surgery in bronchiectasis?

Answer 9

Bronchiectasis affecting one lobe of lung only with good fitness