8.2 Interstitial Lung Disease Flashcards
What is the interstitium?
The space between the alveoli and the capillaries
What are the symptoms of interstitial lung disease?
Shortness of breath
Cough
What would be found on examination of a patient with interstitial lung disease?
Cyanosis Tachycardia Tachypnoea Decreased chest movements Coarse crackles Clubbing Signs of cor pulmonale
What are some causes of interstitial lung disease?
Asbestos exposure Radiation and chemotherapy Sarcoidosis Idiopathic Rheumatoid arthritis
What is idiopathic pulmonary fibrosis?
Fibrosis around the alveoli inhibits gas exchange. Most common form of idiopathic fibrosis.
What is asbestosis?
Asbestos enters the lungs and forms plaques causing pleural thickening.
What is drug induced ILD?
Interstitial lung disease caused by medication such as methotrexate, amiodarone and nitrofurantoin.
How is sarcoidosis treated?
Steroids
What is the function of pleural space?
Allows coupled movement of the lung and chest wall
How is the pleural membrane innervated?
Parietal layer has somatic, parasympathetic and sympathetic innervation via the phrenic and intercostal nerves.
Visceral layer is devoid of somatic innervation.
Where is pleural fluid produced?
The parietal pleura from capillary filtration.
Why might there be increased production of pleural fluid?
Hydrostatic pressure increase
Oncotic pressure decrease
Lung interstitial fluid increase
Why might there be decreased absorption of pleural fluid?
Lymphatic blockage
Elevated venous pressure
How can a sample of pleural fluid be obtained?
Thoracocentesis
When is pleural fluid considered an exudate?
Pleural fluid protein/ serum protein is >0.5
Pleural fluid lactate dehydrogenase/ serum LDH is >0.6
If the pleural fluid is an exudate, what might this suggest?
Infection, malignancy, PE, asbestos
What is an empyema?
Pus in the pleural fluid
When may an empyema occur?
Severe infection
What is a haemothorax?
Blood in the pleural fluid
When may a haemothorax occur?
Trauma or iatrogenic
What is a chylothorax?
Digestive fluid in the pleural fluid
What is a pneumothorax?
Air in the pleural cavity
What may a transudate pleural fluid suggest?
Heart failure
Cirrhosis
Nephrotic syndrome
What is a primary pneumothorax?
Occurs spontaneously in healthy patients
What is a secondary pneumothorax?
Caused by an underlying lung disease
How are pneumothoraxes treated?
If admitted:
High O2 flow
Aspiration
Or chest drain
What is a tension pneumothorax?
Clinical diagnosis
Symptoms- tachycardic, hypotensive, absent chest sounds, decreased chest expansion, mediastinum pushed away from affected side.
List some congenital chest wall problems
Pectus deformities
Scoliosis
Kyphosis
Muscular dystrophy
List some acquired chest wall problems
Ankylosing spondylitis
Motor neurone disease
Trauma
Iatrogenic
