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Symptoms of the Lung > Cough Cough > Flashcards

Cough Cough Flashcards

1
Q

What are the symptoms for diffuse interstitial diseases?

A

dyspnea, tachypnea, and cyanosis (later)

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2
Q

What reductions do you see in diffuse interstitial lung diseases?

A

diffusion capacity, volumes, and compliance (fibrotic)

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3
Q

X-ray for diffuse interstitial lung diseases?

A

diffuse infiltration by small nodules, irregular lines or shadows

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4
Q

In later stages of diffuse interstitial lung diseases what do you see?

A

pulmonary hypertension and right-sided CHF. Also advanced lesions–> end stage or honeycomb lung

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5
Q

IPF/UIP symptoms (EARLY)

A

40-70 year old with increasing dyspnea (getting worse) with a dry cough

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6
Q

IPF/UIP symptoms (LATE)

A

hypoxemia, cyanosis, clubbing

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7
Q

IPF treatment

A

Lung transplant or die within three years

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8
Q

NSIP

A

46-55 year old (younger than IPF) with a cough and dyspnea that has been going on for months

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9
Q

NSIP treatment

A

STEROIDS

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10
Q

COP symptoms

A

cough and dyspnea

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11
Q

COP X-ray

A

subpleural or peribronchial areas of consolidation

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12
Q

COP treatment

A

some recover spontaneously without treatment; MOST treated with steroid therapy for > 6 months

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13
Q

CWP: Anthracosis

A

asymptomatic

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14
Q

Simple CWP can cause what? and usually involves what?

A

Upper lobes and upper zones of lower lobes. Can cause Centrilobular emphysema

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15
Q

CWP course

A

usually benign…miler forms of complicated CWP exist without lung function abnormalities

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16
Q

Caplan syndrome

A

RA and pneumoconiosis. Rapid development of lung nodules. Occurs with CWP, asbestosis, and silicosis

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17
Q

Silicosis presentation

A

decades after exposure

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18
Q

silicosis is associated with

A

an increased susceptibility to TB

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19
Q

X-ray in silicosis

A

nodules in the upper lung zones

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20
Q

Clinical symptoms in silicosis

A

slow development of impaired pulmonary function; dyspnea occurs late in disease with massive fibrosis

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21
Q

Asbestos exposure linked to:

NOTE: LOWER LOBES–>middle and upper are involved later

A

fibrous pleural plaques, pleural effusions, interstitial fibrosis, bronchogenic carcinoma and mesotheliomas, laryngeal and extrapulmonary tumors

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22
Q

Clinical for asbestos-related disease (ARD)

A

dyspnea and PRODUCTIVE cough. Symptoms usually begin 20+ years after exposure

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23
Q

Asbestos X-Ray

A

irregular linear densities in LOWER lobes

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24
Q

bilateral hilar LAD or lung involvement (CXR)

A

sarcoidosis

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25
Q

sarcoidosis lymph nodes, spleen, liver and bone marrow

A

Lymph nodes: hilar and mediastinal enlarged and calcified
Spleen: involved in 75% but only 20% enlarged
Liver: granulomas in portal tracts
BM: usually bones of hands and feet

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26
Q

Milkulicz syndome (sarcoidosis)

A

lacrimal gland involvement + bilateral parotid, submaxillary and sublingual glands

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27
Q

Clinical of sarcoidosis

A

insidious onset of dyspnea, cough, CHEST PAIN, and possible hemoptysis. Also constitutional symptoms (fever, fatigue, anorexia, weight loss and night sweats

28
Q

insidious onset of dyspnea, cough, CHEST PAIN, and possible hemoptysis. Also constitutional symptoms (fever, fatigue, anorexia, weight loss and night sweats

A

Clinical of sarcoidosis

29
Q

40-70 year old with increasing dyspnea (getting worse) with a dry cough

A

IPF/UIP (EARLY)

30
Q

hypoxemia, cyanosis, clubbing

A

IPF/UIP (LATE)

31
Q

46-55 year old (younger than IPF) with a cough and dyspnea that has been going on for months

A

NSIP

32
Q

dyspnea and PRODUCTIVE cough. Symptoms usually begin 20+ years after exposure

A

Clinical for asbestos-related disease (ARD)

33
Q

dyspnea, tachypnea, and cyanosis (later)

A

What are the symptoms for diffuse interstitial diseases?

34
Q

CXR of sarcoidosis

A

bilateral hilar LAD or lung involvement

35
Q

Sarcoidosis course

A

UNPREDICTABLE

  • 2/3 recover with minimal or no residual manifestations
  • 20% with permanent loss of some lung function or visual impairment
  • 10-15% die of cardiac, lung or CNS disease (progressive pulmonary fibrosis and cor pulmonale)
36
Q

Farmers lung (hypersensitivity pneumonitis)

A

inhaled SPORES of thermophilic actinomycets

37
Q

Pigeon breeder’s lung (hypersensitivity pneumonitis)

A

inhaled PROTEINS from feathers or excretions

38
Q

Humidifier Lung (hypersensitivity pneumonitis)

A

inhaled thermophilic bacteria from heated water reservoirs (hot tube even)

39
Q

Clinical for acute form of hypersensitivity pneumonitis

A
  • fever, dyspnea, cough and elevated WBC

- symptoms begin 4-6 hours after re-exposure

40
Q

hypersensitivity pneumonitis X-ray

A

diffuse nodular infiltrate

41
Q
  • fever, dyspnea, cough and elevated WBC

- symptoms begin 4-6 hours after re-exposure

A

Clinical for hypersensitivity pneumonitis

42
Q

Chronic form (untreated): clinical for hypersensitivity pneumonitis

A

PROGRESSIVE dyspnea and cyanosis (decreased lung capacity and compliance)

43
Q

acute eosinophilic pneumonia is most likely a

A

hypersensitivity response to inhaled antigens (NOT NOT NOT food or drug)

44
Q

acute eosinophilic pneumonia clinical

A

RAPID fever, dyspnea and hypoxemia–> respiratory failure

BAL shows > 25% eosinophils

45
Q

acute eosinophilic pneumonia treatment

A

STEROIDS

46
Q

RAPID fever, dyspnea and hypoxemia–> respiratory failure

BAL shows > 25% eosinophils

A

acute eosinophilic pneumonia clinical

47
Q

Loeffler’s Syndrome =

A

simple pulmonary eosinophilia

48
Q

Loeffler’s Syndrome or simple pulmonary eosinophilia is most likely…

A

a hypersensitivity rxn to food or drugs (sulfa drugs)

*check history

49
Q

X-ray of Loeffler’s Syndrome

A

prominent IRREGULAR lung densities (one side bigger than other)

50
Q

Secondary pulmonary eosinophilia is seen in…

A

seen in parasitic, bacteria, and fungal infections

51
Q

Secondary pulmonary eosinophilia is associated with

A

asthma and allergic bronchopulmonary aspergillosis

52
Q

Chronic eosinophilic pneumonia may be associated with…

A

autoimmune shit…RA, polyarteritis nodosa, scleroderma, ulcerative colitis.

53
Q

Chronic eosinophilic pneumonia

Gross and histology

A

Gross: peripheral lung consolidations
Histology: lymphocytic and eosinophilic aggregates in septal walls and alveoli

54
Q

Chronic eosinophilic pneumonia clinical

A

high fever, night sweats, and dyspnea (responds to steroids)

55
Q

Desquamative Interstitial Pneumonitis (DIP) (less side or spectrum)

A
  • smokers (men)
  • 4th or 5th decade symptoms begin (30-50)
  • onset of dyspnea and dry cough over weeks to months
  • EXCELLENT response to steroid therapy
56
Q

Respirtary Bronchiolitis- Associated Interstitial Lung Disease (RB-ILD) * worse side of spectrum

A
  • significant symptoms (dyspnea and dry cough)
  • men 4th to 5th decade
  • improves with cessation of smoking
  • more fibrosis of airways and a little more chronic inflammation with pigmented SMOKERS macrophages in RESPIRATORY BRONCHIOLES and alveoli
57
Q

DIP vs RB-ILD

A
  • DIP pigmented macs predominately in alveolar space
  • Steroid work excellent for DIP
  • RB-ILD macs in respiratory bronchioles AND alveoli space
  • RB-ILD = more fibrosis of airway and a little more chronic inflammation
58
Q

AQUIRED PAP (pulmonary alveolar proteinosis)

A
  • 90% of cases do to acquired
  • granulocyte macrophage colony stimulating factor (GM-CSF) ANTIBODIES–>destruction of GM-CSF causes impaired surfactant clearance by alveolar macrophages
59
Q

Congenital PAP

A

rare cause of neonatal respiratory distress syndrome (caused by various mutations)

60
Q

Secondary PAP etiologies (very uncommon)

A
  • silicosis
  • immunodeficiency
  • malignancies
61
Q

PAS- positive

A

PAP

62
Q

minimal lung inflammation w/ consolidation of lung parenchyma. CONTAINS CHOLESTEROL CLEFTS

A

PAP

63
Q

PAP (pulmonary alveolar proteinosis)

A

ADULTS with insidious onset of dyspnea and PRODUCTIVE cough with expectoration of GELATINOUS MATERIAL

64
Q

PAP x-ray

A

scattered areas of consolidation

65
Q

PAP course

A

some show resolution and others progress to respiratory failure

66
Q

PAP treatment

A
  • Bronchoalveolar lavage used for removing alveolar precipitate
  • GM-CSF therapy works in 50% of cases
  • CONGENITAL PAP is fatal in 3-6 months without lung transplant

Symptoms of the Lung (1 decks)

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