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Bronchiectasis — UKMLA MCQ

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HardRespiratory MedicineBronchiectasisUKMLAMRCGP AKTPARA

A 46-year-old with bronchiectasis develops increased cough, purulent sputum and breathlessness but is haemodynamically stable. Previous sputum grew beta-lactamase-negative Haemophilus influenzae susceptible to amoxicillin. What is the best initial approach?

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Correct answer: B — Send sputum and start a 14-day amoxicillin course guided by prior culture

B is correct. Sputum should be obtained before antibiotics when possible, but empirical treatment can begin using prior microbiology; BTS lists amoxicillin 500 mg three times daily for 14 days for susceptible H influenzae. A delays treatment unnecessarily. C uses a short pneumonia-style course and loses culture information. D is neither the standard duration nor eradication regimen. E is disproportionate without severe illness, resistance or oral-treatment failure.

Reference: BTS guideline for bronchiectasis in adults: https://www.brit-thoracic.org.uk/clinical-resources/guidelines/bronchiectasis-in-adults/ GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map