Bronchiectasis and Cystic Fibrosis Quiz

See Investigations. Option B is correct because high-resolution CT (HRCT) of the chest is the gold-standard investigation for confirming bronchiectasis. A high-resolution CT scan takes thin slices of the lungs, which shows the airways in fine detail. Bronchiectasis is diagnosed when a bronchus is more dilated than the adjacent blood vessel, and the walls of the bronchi are often thickened. The classic appearance is the signet ring sign: a widened dark bronchus seen next to a smaller, white pulmonary artery, which together look like a ring with a jewel. A bronchus that is clearly larger than its accompanying artery is therefore abnormal. The history gives the clue (daily sputum, recurrent infection, sometimes haemoptysis), and CT confirms it. Further tests then look for the underlying cause. A neat memory aid is that the ring is the signet, and the stone is the artery.

• Test: high-resolution CT (HRCT) of the chest is the gold-standard investigation for confirming bronchiectasis.
• Criterion: a bronchus more dilated than the adjacent blood vessel, often with thickened walls.
• Signet ring sign: a widened dark bronchus next to a smaller, white pulmonary artery.

Always match the test to the question: structure needs imaging, function needs spirometry, and gas exchange needs blood gases.