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Bronchiectasis — RCPSC IM MCQ

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HardRespirologyBronchiectasisRCPSC IM

A 58-year-old woman has chronic daily purulent sputum and three infective exacerbations per year. CT chest shows cylindrical bronchiectasis in both lower lobes. Sputum culture repeatedly grows Pseudomonas aeruginosa, immunoglobulins are normal, and she has no cystic fibrosis. What is the most appropriate management?

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Correct answer: D — Airway clearance training, sputum-guided antibiotics and specialist consideration of inhaled antibiotic therapy

Bronchiectasis management includes airway clearance, vaccination, treating exacerbations according to cultures and specialist strategies for frequent exacerbations with Pseudomonas. Chronic systemic steroids are not routine therapy.

Reference: Canadian Thoracic Society bronchiectasis practice; ERS bronchiectasis guideline