Diffuse Parenchymal Lung Disease Flashcards

1
Q

What is the pathophysiology in parenchymal lung disease?

A

Lung interstitium becomes expanded by an inflammatory cell infiltrate (pneumonitis). This impairs gas exchange and causes breathlessness.

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2
Q

What is this a presentation of?

Dyspnoea on exertion, non-productive cough, abnormal breath sounds, abnormal CXR, restrictive pulmonary spirometry.

A

Diffuse parenchymal lung disease

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3
Q

What are the known causes of diffuse parenchymal lung disease?

A
  1. Occupational/environmental (asbestosis, silicosis, coal worker)
  2. Drugs - nitrofurantoin, amiodarone, sulfasalazine
  3. Hypersensitivity reactions
  4. Infections - TB, fungal, viral
  5. GORD
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4
Q

Which systemic disorders is diffuse parenchymal lung disease associated with?

A
  1. Sarcoidosis
  2. RA
  3. SLE, connective tissue disease, Sjogren’s syndrome
  4. UC, autoimmune thyroid disease, renal tubular acidosis
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5
Q

What is the treatment for idiopathic pulmonary fibrosis?

A

Supportive, oxygen, high dose steroids, palliative care.

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6
Q

What is the work-up for a suspected diffuse parenchymal lung disease?

A
  1. Meticulous history including occupational and environmental exposure in detail.
  2. CXR may show reticular-nodular shadows
  3. High resolution CT
  4. Lung biopsy for histological examination is sometimes needed for diagnosis but is not first line.
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7
Q

What are the long-term complications of diffuse parenchymal lung disease?

A
  1. Cor pulmonale
  2. Fibrosis of the lung tissue causes obliteration of pulmonary arterioles - gradual development of pulmonary hypertension
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