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2a Resp > Chronic Interstitial Lung Disease (ILD) > Flashcards

Chronic Interstitial Lung Disease (ILD) Flashcards

1
Q

What is the most common ILD?

A

Idiopathic Pulmonary Fibrosis

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2
Q

Which group of people is pulmonary fibrosis commonly seen in?

A

Men over 60 who smoke

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3
Q

What are risk factors for idiopathic pulmonary fibrosis?

A

Smoking
Occupational (eg dust)
Drugs (methotrexate)
Viruses (EBV, CMV)

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4
Q

What does the pulmonary fibrosis lead to?

A

Type 1 respiratory failure

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5
Q

What are symptoms of pulmonary fibrosis?

A

Exertional dyspnoea
Dry unproductive cough

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6
Q

How is pulmonary fibrosis diagnosed?

A

Spirometry: restriction

FEV1:FVC is greater than 0.7 but low FVC, below 0.8

High resolution chest CT:
Ground glass lungs and traction bronchiectasis

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7
Q

Bronchiectasis is i_____ d_____ of bronchi and bronchioles within areas of pulmonary fibrosis

A

irreversible dilatation

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8
Q

What is treatment for pulmonary fibrosis?

A

Smoking cessation

Vaccines

Meds to reduce scarring worsening: Pirfenidone, Nintendinib

Surgery (lung transplant)

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9
Q

P_____ consists of occupationally acquired ILDs

A

Pneumoconiosis

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10
Q

Silicosis is caused by inhaling s_____ ____

A

silicon dioxide

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11
Q

What does silicon dioxide in the lungs cause?

A

Causes inflammation and scarring
The particles reduce the lung’s ability to take in oxygen

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12
Q

What is visible on a chest XR of a patient with silicosis?

A

Eggshell calcification at hilar lymph nodes

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13
Q

What substance other than silicon dioxide can commonly cause pneumoconiosis?

A

Asbestos

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14
Q

What does inhalation of asbestos cause?

A

Scarring and thickening of the pleura.
Increases risk of mesothelioma and Type 1 respiratory failure

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15
Q

Sarcoidosis is an idiopathic g______ disesae

A

granulomatous

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16
Q

Who typically is affected by sarcoidosis?

A

20-40 y/o Afrocaribbean women

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17
Q

What are symptoms of sarcoidosis?

A

Fever
Fatigue
Dry cough
Dyspnoea
Uveitis
Lupus pernio (blue-red nodules on nose and cheeks)

18
Q

Sarcoidosis is a chronic disease of unknown cause characterised the by the enlargement of l____ n____ in many parts of the body and widespread appearance of g____ derived from the reticuloendothelial system

A

lymph nodes
granulomas

19
Q

How is sarcoidosis diagnosed?

A

Chest XR showing bilateral hilar adenopathy (swollen glands) and pulmonary infiltrates

Diagnostic = biopsy

20
Q

What does a biopsy of sarcoidotic tissue show?

A

Non caseating granuloma

21
Q

What increases with presence of granulomas?

A

Serum calcium and serum ACE

22
Q

What is the treatment for sarcoidosis?

A

Corticosteroids

23
Q

Sarcoidosis is staged 1-_

A

4

24
Q

Lofgren syndrome is a specific acute clinical presentation of s____ s____

A

systemic sarcoidosis

25
Q

What does the classic triad of Lofgren syndrome consist of?

A

Fever
Erythema nodosum (tender red bumps often symmetrical on shins)
Bilateral hilar adenopathy

26
Q

What type of hypersensitivity reaction is hypersensitivity pneumonitis?

A

Type 3 (immune antibody-antigen complex deposition at lung tissue)

27
Q

What are risk factors of hypersensitivity pneumonitis?

A

Occupation eg farming
Bird-keeping

28
Q

Name some types of Hypersensitivity Pneumonitis

A

Farmer’s lung (most common, from mouldy hay)

Pigeon fancier’s lung from bird droppings

Malt worker’s lung
Cheese worker’s lung
Humidifier fever

29
Q

What is the treatment for hypersensitivity pneumonitis?

A

Remove the allergen

30
Q

What type of hypersensitivity reaction is Goodpasture’s syndrome?

A

Type 2

31
Q

What type of antibodies are made in Goodpasture’s syndrome and what do they attack?

A

Anti-GBM (glomerular basement membrane)
Attacks lungs and kidneys

32
Q

What does Goodpasture’s cause to happen in the lungs and kidneys?

A

Lung fibrosis
Glomerulonephritis

33
Q

How is Goodpasture’s diagnosed?

A

Lung and kidney biopsy showing damage and immunoglobulin deposition

Serology: Anti-GBM positive

34
Q

How is Goodpasture’s treated?

A

Supportive
Corticosteroids
Plasma exchange to get rid of Anti-GBM

35
Q

What is Wegener’s Granulomatosis also called?

A

Granulomatosis with polyangiitis (GPA)

36
Q

Wegener’s Granulomatosis is the presence of both granulomatosis and ______

A

polyangiitis

37
Q

What is polyangiitis?

A

Vasculitis affecting small and medium vessels. Unknown cause, no genetic link.
Typically causes ENT, lung and kidney symptoms (ELK)

38
Q

Granulomatosis with polyangiitis (GPA also called Wegener’s Granulomatosis) can lead to inflamed, narrowed blood vessels and inflammatory tissue masses (granulomas). What is the effect of the narrow blood vessels and granulomas?

A

Narrow blood vessels means reduced blood flow and oxygen reaching body’s tissues.
Granulomas can destroy normal tissue

39
Q

Wegener’s granulomatosis is a _-____ associated vasculitis

A

c-ANCA (antineutrophilic cytoplasmic antibody)

40
Q

What are symptoms of Wegener’s granulomatosis?

A

(Think ELK: ENT, lungs, kidneys)

ENT: saddle-shape nose, ear infection

Lungs: diffuse alveolar haemorrhage and haemoptysis

Kidneys: glomerulonephritis and haematuria

41
Q

How is Wegener’s granulomatosis diagnosed?

A

ANCA positive

However so is MPA (microscopic polyangiitis) and EGPA (Eosinophilic granulomatosis with polyangiitis)

42
Q

What is treatment for Wegener’s granulomatosis?

A

Corticosteroids
Immunosuppression eg Rituximab

2a Resp (15 decks)

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