Hypersensitivity Pneumonitis Flashcards

1
Q

Hypersensitivity Pneumonitis

A

Inhalation of allergens provoke hypersensitivity reaction => IgG & immune complexes deposited in walls of alveoli & bronchioles causing inflammation.

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2
Q

Type of Hypersensitivity reaction

A

Type III or Type IV

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3
Q

How long does it take for symptoms to appear in acute hypersensitivity Pneumonitis?

A

4-6 hours after acute exposure

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4
Q

Chronic inflammatory disease

A

Repeated low dose antigen exposure over time (years) resulting in granuloma formation & obstructive bronchitis in small airways & interstitium.

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5
Q

Cause of farmers lung

A

Spores from hay

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6
Q

Cause of pigeon fanciers lung

A

Avian proteins in bird poo

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7
Q

Cause of malt workers lung

A

Aspergillus from malt

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8
Q

Causes

A

Spores, proteins, aspergillus, drugs & 30% idiopathic.

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9
Q

Symptoms of acute HP

A

Dry cough, dyspnoea, fever, myalgia, fever, rigors

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10
Q

Signs of acute HP

A

Pyrexia, crackles, hypoxia

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11
Q

Symptoms of chronic HP

A

Progressive, increasing or exertional Dyspnoea, progressive cough, weight loss.

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12
Q

Signs of chronic HP

A

Crackles, clubbing

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13
Q

Investigations for acute HP

A

Bloods, CXR, spirometry

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14
Q

Investigations for chronic HP

A

Blood, CXR, spirometry, DCLA,

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15
Q

Investigations for chronic HP

A

Blood, CXR, spirometry, DCLO.

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16
Q

Bloods for acute HP

A

Neutrophilia & increased ESR

17
Q

CXR for acute HP

A

Upper zone consolidation, widespread pulmonary infiltrates.

18
Q

Spirometry for acute HP

A

Reversible restrictive pattern

19
Q

Blood for chronic HP

A

Positive serum precipitants

20
Q

CXR for chronic HP

A

Upper lobe fibrosis, honeycomb lung

21
Q

Spirometry for chronic HP

A

Restrictive defect: Low FEV1 & FVC, high or normal ratio, low gas transfer.

22
Q

DCLO for chronic HP

A

Reduced.

23
Q

Treatment for Acute HP

A

Avoid allergen, oxygen, steroid (oral prednisolone), anti-fibrotic therapy in cases of progressive fibrosis (pirfenidone or nintedanib)

24
Q

Treatment for Chronic HP

A

Avoid allergen & long term steroids

25
Q

Why are corticosteroids used?

A

To decrease inflammation

26
Q

Why are immunosuppressants used?

A

To decrease production of antibody.