Bronchiectasis

Exam Cram

• Disease defined by irreversible widening of bronchioles

• Presentation: productive sputum ++, haemoptysis

• Spirometry: obstructive or mixed picture

• Management: pulmonary rehab

Outline

Assessment

History

• Chronic productive cough (non purulent)

• Recurrent LRTI

• Previous pertussis

Examination

• Bibasal inspiratory crackles

Investigations

• CXR- clear

• CT-Thorax: enlarged bronchioles

• PFT: obstructive (rarely restrictive)

Diagnosis

Diagnostic criteria: enlarged bronchioles on CT

Classification: (aetiology)

• Rheumatoid Arthritis 

• Whooping Cough 

• Kartagener's Syndrome 

• Cystic Fibrosis 

Management

Chronic

• Supportive

Med Reg Notes

Imaging findings: broncho-arterial ratio > 1.5

Pseudomonas colonisation associated with worse short term outcomes, therefore eradication is performed with nebulised antibiotics (tobramycin +/- short term antibiotics). 

Inhalers, prednisolone or mucloytics aren't used unless there is co-morbid COPD or asthma. 

Resources & References

Written in 2025