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Bronchiectasis — MRCPCH FOP MCQ

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HardRespiratoryBronchiectasisMRCPCH FOP

A 10-year-old boy has a daily productive cough for 18 months, two admissions with pneumonia and persistent crackles over the left lower zone. Spirometry shows an obstructive pattern with poor reversibility. What is the most appropriate investigation?

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Correct answer: A — High-resolution CT chest after specialist review

Persistent wet cough, recurrent pneumonia and fixed crackles raise concern for bronchiectasis, with high-resolution CT used to confirm the diagnosis in specialist care. A peak flow diary may help asthma assessment but would not explain persistent focal crackles. A throat swab may guide infection management but does not define airway damage. The pearl is that chronic wet cough in children should not be dismissed as habitual cough.

Reference: BTS Guideline for non-CF bronchiectasis in children; NICE CKS Cough