Diffuse Lung Disease Flashcards
What kinds of acute processes cause a diffuse lung pattern?
ACUTE due to the presence of: 1. water – from altered Starling forces in pulmonary oedema 2. inflammation – due to acute inhalational injury from toxic fumes or acute drug toxicity; acute infection eg influenza 3. blood – diffuse leakage from inflamed vessels in vasculitis
What kind of subacute or chronic processes cause a diffuse lung pattern?
A huge and alarming list of the so-called: - interstitial diseases usually presenting over months to years
What are the two main conditions associated with clubbing?
Specific to *idiopathic pulmonary fibrosis and cyanotic heart disease (clubbing usually associated with chronic processes)
Ix for diffuse lung disease
• Respiratory function tests (FEV1:FVC ratio is normal or increased) • High resolution CT of chest (“HRCT”) • Blood tests – to screen for systemic illness and connective tissue disease e.g. ANCAs • Echocardiogram – may identify left ventricular dysfunction assess for the presence of pulmonary hypertension (especially relevant in connective tissue diseases) • Lung biopsy – not required in all cases, the decision to obtain a trans- bronchial bioppsy through a bronchoscope or an “open” biopsy at thoracoscopic surgery is made at specialist level (1. Hx 2. Px 3. Lung function test and oximetry report 4. radiology)
What makes up the interstitium?
Interstitium: - alveolar lining cell - epithelial basement membrane (connective tissue, with its passing and fixed cell populations, and fluid traffic) - endothelial basement membrane - endothelial lining cell
What does this LFT show?
• Spirometry shows reduced vital capacity, and a normal or even high ratio of FEV1 toFVC -iea restrictive pattern • CO diffusion capacity is markedly reduced in keeping with very impaired gas exchange •Pattern typical of a diffuse lung disease - in this case pulmonary fibrosis
Describe this patter of alveolar pattern of diffuse lung disease.
Opacity is often described as fluffy, cotton wool like or cloud like
What are the different types of insterstitial lung patters on CXR?
What does this HR CT show?
Honeycomb does not indicate idiopathic pulmonary fibrosis specifically, but gives indication of severity of disease.
