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Patho 2 > 19 ILD > Flashcards

19 ILD Flashcards

1
Q

• What are the 2 types of lower resp diseases?

A
  1. Obstructive —>contraction of airway —> obs of airflow—> ⬇️ FEV1 —> prob during inhalation
  2. Restrictive —> lung size affected —> ⬇️ of lung volume —> prob during exhalation
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3
Q

• What’s similar & what’s diff btwn obs and restrictive?

A

similar: syms like cough and shortness of breath
Diff: the abnormality mechanism ( place affected )

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4
Q

• Where is the interstitium?

A

all over the lung btwn alveoli and capillaries from epical to base & lateral ventral sides

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5
Q

• What is found in the interstitium?

A

An interstial space within a tissue or organ

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6
Q

• In which tissue can we find the interstial space?

A

Specifically the tissue between the pulmonary alveoli and the bloods

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7
Q

• What part of the lung can ILD affect?

it can affect all the lung or be patchy ( in specific site )

A

it can affect all the lung or be patchy ( in specific site )

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8
Q

• What are the cells available in the interstitium?

A
  1. macrophages
  2. Lymphocytes
  3. Mesenchymal: fibroblasts/myofibroblasts/smoothMC
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9
Q

• What are the comp of the basement mem of ECM?

A
  1. Collagen ( type 1 & 3 )
  2. Elastin
  3. Fibronectin
  4. Proteoglycans
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10
Q

• What are the components of the interstitium?

A
  1. Fluid —> blood plasma
  2. Cellular comp —> cells
  3. Extracellular matrix comp —> basement mem comp
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11
Q

• Is the interstitium normally visible radiographically?

A

No, only when there is disease bcz it causes edema / fibrosis / tumor —> increase its volume —> become visible

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12
Q

• What is the interstitium?

A

the space between the air sacs (alveolus) and the capillary vessel and extends throughout the lungs

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13
Q

• What are the main functions of the interstitium?

A
  1. transportation system for nutrients and solutes
  2. Regulation: barrier to plasma constituents passing from capillaries to alveolar spaces
  3. Structural support for endo/epithelial cells & parenchymal cells
  4. Mechanical support to the lung
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14
Q

• What happens in the case of ⬆️ ECM comp deposition?

A

stiffness of the lung —> doesn’t expand easily

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15
Q

• What are interstitial lung diseases?

A

a group of lung diseases affecting the interstitium that are charactized by inflammation or scarring or both

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16
Q

• Where does the inflammation / scarring occur?

A
  1. Interstitium
  2. Alveoli
  3. Bronchioles
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17
Q

• How is the inflammation / scarring?

A

it can be patchy or diffused all over the lung

18
Q

• What are the results if inflammation &/or scarring?

A
  1. Disrupts the tissue
  2. ⬇️ in the ability of lungs to exchange gases
  3. ⬇️ in lung volume
19
Q

Why does ILD’s progression vary from one type to another?

A

bcz of diff etiology and development rate

20
Q

• If you suspect ILD, what do you try to do?

A
  1. X-ray
  2. Blood tests
  3. Spirometry
21
Q

• What are the adv of spirometry?

A
  1. Very specific

2. Differential diagnosis btwn asthma / COPD /ILD

22
Q

• Are all ILDs chronic?

A

No, but majority are chronic some are driven by infection —> acute

23
Q

• What are the characteristics of chronic ILD?

A
  1. Always there
  2. Slowly develops
  3. Irreversible damage
24
Q

• What are the causes & types of ILD?

A
  1. Sys diseases: auto-immune / connective tissue disease
  2. Occupational / environmental
  3. Infection: interstitial pneumonitis /acute inter pneumonitis
  4. Genetic diseases: hermansky-pudlak syndrome
  5. Idiopathic diseases: pulmonary fibrosis (no known cause)
25
Q

• What are the environmental/occupational causes?

A

Diseases associated with a specific exposure to an agent known to damage the lungs

26
Q

• What are the agents that can cause damage to the lungs?

A
  1. Asbestos
  2. Tobacco smoke
  3. Coal mines
  4. Farmers
  5. Meds like bleomycin / radiation
27
Q

• What is hermansky-pudlak syndrome?

A

It is albinism (ocalocatanous de-pigmentation) in addition to de-pigmentation, they may have platelet abnormality / ILD

28
Q

• What happens to coal miners’ lungs?

A

Normal lung —> black spots from coal dust —> prog massive fibrosis ( BLACK LUNG DISEASE / PNEUMOCONIOSIS )

29
Q

• What is honey comb lung?

A

if the lung appears as honeycomb in a CT scan or X-ray —> ILD

30
Q

• Why is honeycomb lung called like that?

A

bcz of the dense connective tissue —> which indicates fibrosis —> which is idiopathic

31
Q

• What happens in honeycomb lung?

A

Damage to alveoli —> ⬆️ alveolar size

32
Q

• What is the most common characteristic of ILD?

A

Fibrosis

33
Q

• What does the thickening of interstitial tissue result in?

A

Stiffness —> lung restrictions

34
Q

• What is the diff btwn lung biopsies in each case?

A

predominance of fibrosis: poor prognosis + advanced disease

Predominance of inflammation: better prog + can respond to treatment if initiated early

35
Q

• What are the syms of ILD?

A
  1. cough ( dry not productive )
  2. Breathlessness ( developing slowly )
  3. Tiredness & fatigue
  4. Weight loss
36
Q

• What is used to diagnose ILD?

A
  1. Chest x-ray
  2. Pulmonary function testing (spirometry )
  3. Computed tomography ( CT scan )
  4. Lung biopsy ( bronchoscopy )
37
Q

• Why do we use spirometry?

A

to measure flow/volume loops

38
Q

• What does spirometry show?

A
  1. ⬇️ RV
  2. ⬇️ TLC
  3. ⬇️ FVC
  4. poor lung compliance
  5. Normal or ⬆️ FEV1 / FVC ratio
39
Q

• How do they take lung biopsies?

A

by using an endoscope w/scissor like tool through the mouth / nose into the airways to take the sample

Patho 2 (2 decks)

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