Chpt 26-Interstitial Lung Disease Flashcards
What impairs gas exchange in interstitial lung disease
Vq mismatching
Shunt
Decreased diffusion across interstitium
Signs and symptoms of ild
Dyspnea
Nonproductive cough
What are breath sounds with ild
Bilateral fine inspiratory crackles
What does chest X-ray with ild look like
Reduced lung volume with bilateral opacities
Ipf will have honeycomb appearance
What will present on pft for ild
Restrictive pattern
Reduced lung volumes
Reduced dlco
Normal spirometry but reduced dlco suggests?
Ipf and emphysema
Patients who develop ground glass opacities within 6. Months of radiation can be treated with
Oral corticosteroids for acute inflammation
Treatment for patients who develop ild more than 6 months post radiation can be treated with
Supportive care only, corticosteroids don’t help
Bleomycin induced ild is made worse by
High levels of oxygen
What is hypersensitivity pneumonitis
A cell mediated immune reaction to inhaled agents
Hypersensitivity pneumonitis will cause a reaction after?
Previously being exposed to an irritant, the patient will react on reexposure
Symptoms of hypersensitivity pneumonitis
Dyspnea Chest pain Fever Chills Malaise Productive cough
Common antigens that cause hypersensitivity pneumonitis include
Bacteria-mushroom compost, mouldy hay, heated water reservoirs
Fungi-mouldy hay, barley, cheese, water, damp wood
Chemicals-paint, plastic, resin
Treatment for hypersensitivity pneumonitis
Avoiding triggers
Corticosteroids
What are the three most common occupational diseases
Asbestosis
Chronic silicosis
Coal workers pneumoconiosis
What would you expect on a chest X-ray of a patient with asbestosis
Plaques Fibrosis Effusions Atelectasis Parenchyma scarring
What increases risk of lung cancer synergistically
Asbestos exposure and cigarette smoking
Symptoms of benign asbestos pleural effusions
Chest pain, fever and dyspnea
Treatment for benign asbestos pleural effusions
Draining the effusion to reduce symptoms
Treatment for asbestosis
Provide supportive care as patients are typically too old for lung transplant
Jobs that have high risk of asbestos exposure
Ship building and insulation work
Occupations that have exposure to silica
Mining
Tunneling
Sandblasting
Foundry work
Chest X-ray in silicosis will present as
Upper lung abnormalities with small nodular opacities in central lung
What would pft findings be in chronic silicosis
Mixed obstructive and restrictive with reduced dlco
