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WI-18 Pulmonary > Disease States I > Flashcards

Disease States I Flashcards

1
Q

multi-system inflammatory disease of unknown etiology causing interstitial lung disease

A

sarcoidosis

MC lung, lymph node, eyes, skin

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2
Q

sarcoidosis causes which specific forms of pulmonary disease

A

pulmonary fibrosis

hilar lymphadenopathy

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3
Q

sarcoidosis pathophysiology

A

exaggerated immune response

develop non-caseating granulomatous disease

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4
Q

sarcoidosis epidemiology

A

MC in AA, women

AA disease tend to be more severe and unremitting

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5
Q

sarcoidosis clinical presentation

A

DOE, cough, chest pain

+/- fever, arthralgia, anorexia

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6
Q

systemic clinical manifestations of sarcoidosis

A

pulmonary
cutaneous
ocular
endocrine

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7
Q

pulmonary manifestations of sarcoidosis

A

hilar lymphadenopathy
interstitial lung dz
pulmonary HTN

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8
Q

cutaneous manifestations of sarcoidosis

A

erythema nodosum
skin plaques
panniculitis
violet rash on cheeks, nose

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9
Q

ocular manifestations of sarcoidosis

A

uveitis (can cause blindness)

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10
Q

endocrine manifestations of sarcoidosis

A

hypercalcemia

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11
Q

erythema nodosum

A

skin manifestation of sarcoidosis

large red indurated nodule on extremities

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12
Q

diagnostic study used for sarcoidosis

A

CXR (shows the granules)

HRCT can be used to identify active alveoli’s or fibrosis

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13
Q

lab eval of sarcoidosis

A

LFT’s
dihydroxy vitamin D levels
ACE levels

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14
Q

sarcoidosis dx is confirmed by

A

BIOPSY of lung or lymph tissue

shows non caveating granulomas w/o fungus or TB

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15
Q

sarcoidosis stage I

A

hilar or mediastinal lymphadenopathy only

45-65% of pts @ diagnosis

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16
Q

stage II sarcoidosis

A

lymphadenopathy and parenchymal disease

infiltrates

17
Q

stage III sarcoidosis

A

parenchymal disease (infiltrates only)

18
Q

sarcoidosis treatment

A

given to pts with pulmonary disease - oral corticosteroids over 6 months

NSAIDS for symptomatic relief

19
Q

sarcoidosis prognosis

A

2/3 remit w/in 10 yrs

important prognostic indicator is staging of dz on CXR

20
Q

etiologies of restrictive lung disease

A 
Pleural (trapped lung, empyema)
Alveolar (edema, hemorrhage 
Interstitial (pulmonary fibrosis) 
Neuromuscular (myasthenia gravis, ALS)
Thoracic cage abnormalities (obesity)
21
Q

restrictive lung disease results when

A

poorly compliant chest wall

muscles expand chest wall too weak to create normal neg pressure

pulmonary tissue is poorly expandable

alveoli have poor ability to exchange O2

ventilation

22
Q

test used to diagnose lung disease

A

PFT’s

decreased total lung capacity

23
Q

restrictive lung disease PFT

A

Low lung volumes but normal FEV1/FVC ratio

24
Q

restrictive lung disease and diffusion capacity PFT

A

DECREASED DLCO = interstitial lung disease

NORMAL DLCO - neuromuscular, thoracic cage, pleural etiology)

25
Q

interstitial lung disease

A

diffuse inflammation of the lung causing scaring and thickening of tissue between alveoli and capillaries

RESTRICTIVE + DECREASED diffusion

26
Q

patho of interstitial lung disease

A

injury to lungs (aspiration, smoke, dust) that doesn’t heal properly

patchy replacement of normal tissue with scar tissue and fibroblasts

27
Q

end result of ILD

A

pulmonary fibrosis due to chronic inflammation

28
Q

etiologies of ILD

A

long term exposure to toxins and pollutants

connective tissue diseases

medications and radiation

29
Q

ILD presentation

A

varied

dry cough > 6 months

DOE progressing to DOR

30
Q

diagnosis of ILD – suspect then order

A

history (insidious onset, chronic symptoms)

PE (systemic signs of pulmonary dz - clubbing)

pulmonary function testing (restrictive and DLCO decreased)

+ lab testing, imaging, lavage/bx

31
Q

lab testing ILD

A

arterial blood gas (hypoxemia)

testing for specific etiology

32
Q

imaging ILD

A

HRCT STUDY OF CHOICE

shows fibrosis

33
Q

bronco-alveolar lavage

A

lund tissue biopsy

suggests severity, confirms diagnosis

34
Q

management of ILD

A

treat underlying dz, pulmonology
steroids/immunomodulators
prompt tx of infection
oxygen

35
Q

pneumoconioses

A

collection of interstitial lung diseases caused by occupational exposure to inorganic mineral dust

MC type is asbestosis

36
Q

when to consider pneumoconiosis

A

history, exam, and diagnosis of ILD with occupational exposure risk

37
Q

imaging and pneumoconiosis

A

involvement of upper lobes of lungs

** except asbestosis

38
Q

Black lung

A

coal workers lung

due to coal/dust exposure

upper lobes show coal macule –> fibrosis

39
Q

silicosis

A

upper lob opacity, EGGSHELL clarifications of lymphnodes

ex. stonemason/sandblasting

WI-18 Pulmonary (11 decks)

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