Bronchiectasis due to CFTR-related disease — SCE Respiratory MCQ

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HardRespiratory InfectionsBronchiectasis due to CFTR-related diseaseSCE Respiratory

A 42-year-old man has newly diagnosed bronchiectasis on thin-section CT after recurrent chest infections. He has chronic sinus symptoms and a history of infertility. What is the most appropriate investigation?

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Correct answer: C — CFTR testing and sweat chloride assessment

The best answer is “CFTR testing and sweat chloride assessment”. CFTR testing and sweat chloride assessment is the investigation that most directly resolves the remaining diagnostic or staging uncertainty at this point in the pathway. The alternatives address different questions, have lower expected yield, or would be premature before this result. The remaining choices—“Routine PET-CT, after specialist assessment”, “Cardiac troponin measurement, with clinical reassessment”, “Pleural biopsy, within a respiratory pathway”, “Methacholine challenge alone, after specialist assessment”—are credible in related respiratory presentations, but each addresses a different diagnostic, staging or management decision and does not fit the decisive findings and pathway position in this stem.

Reference: British Thoracic Society guideline for bronchiectasis in adults: https://thorax.bmj.com/content/74/Suppl_1/1