A2- Interstitial Lung Disease Flashcards
What is intersitial space?
It is the liquid space between the alveolar cell wall and capillaries
It is a small space
What is IDL?
Interstitial Lung disease
A ‘potential space’ that is
‘widened’ in interstitial disease by influx of inflammatory and
fibrotic cells/tissue
• Its disruption leads to type 1 Respiratory Failure- hypoxia
• Some forms of ILD’s can involve
not only the interstitial space but
also alveoli and bronchioles.
How are IDLS classified?
How can you further classify
Idiopathic interstitial pneumonias?
What is the Suspected ILD diagnostic approach?
What do you need to ask in a detailed history?
- breathlessness
is it coming and going,
getting worse,
stable
how is it impacting life (can they get dressed) - cough
dry
sputum - exposure
occupation
instruments
damp environment
so hobbies/interests - smoking
- drug history
- family history
- Pmhx
WHat to expect o physical examination?
Crackles (velcro being pulling apart)
Hands
eyes
skin- rashes
Heart disease
Swelling fingers
What are asbestos fibres?
Naturally occurring fibrous mineral silicates - good fire retardant and insulating properties. Tiny fibres that are inhaled.
Occupation wise who would be exposed to asbestos?
Occupational exposure: pipe fitters, plumbers, dockers, miners
What is Absbestosis?
A form of ILD characterised by slowly progressive pulmonary fibrosis caused by inhalation of asbestos fibres. Lungs cannot break down fibres
Immune system keeps attacking/cells release inflammatory chemicals to try and destroy fibres- fails - asbestos is a tough material
Eventually this can lead to fibrosis but often 20- 40 years after exposure - lag phase
Diagnoses for Asbestosis?
history of enough asbestos exposure need occupational history + latency period, ILD on scan, plus exclusion of other causes of that pattern of ILD on scan (i.e. right ILD patterns need to be seen). No easy ‘test’.
Diagnoses for Asbestosis?
history of enough asbestos exposure need occupational history + latency period, ILD on scan, plus exclusion of other causes of that pattern of ILD on scan (i.e. right ILD patterns need to be seen). No easy ‘test’.
Tx for asbestosis?
was no specific treatment for asbestosis.
o Now evidence that anti fibrotic drugs may have a role (await NICE assessment).
o Avoidance of any further asbestos exposure.
o Supportive care.
There is increased risk of Lung Cancer in smokers with asbestos exposure
TRUE OR FALSE
TRUE
What Hypersensitivity Pneumonitis (previously aka EAA)?
A form of ILD that is caused by an immunologic reaction to an inhaled agent/organic antigen. E.g. bird fanciers lung