Interstitial and Occupational Lung Disease Flashcards
What is interstitial lung disease?
Any disease process which affects the lung interstitium being alveoli, terminal branch e.t.c. Slide 3
What are types of Interstitial Lung Disease?
Idiopathic Interstitial Pneumonia
Granulomatous ILD
Idiopathic Pulmonary Fibrosis. Slide 5
What is sarcoidosis?
A non-caseating granulomatous disease of unknown cause due to type IV hypersensitivity. Slide 6
What is the difference between acute and chronic sarcoidosis?
Acute: BHL. arthritis, fever, uveitis, parotits, erythema nodosum.
Chronic: Alveolitis, rashes, effects other organs, skin infiltrations, hypercalcaemia and peripheral lymphadenopathy. Slide 7
What are other diagnosis that could be similar in presentation as sarcoidosis?
TB, lymphoma, carcinoma, fungal infection. Slide 8
How do you treat acute and chronic sarcoidosis?
Acute: self limiting condition (usually no treatment)
Chronic: oral steroids and if that doesn’t work then immunosuppression. Slide 9
What is Extrinsic allergic alveolitis and what type of hypersensitivity is it?
Inflammation of lung tissue caused by atigens breathed in e.g. Thermophilic actinomycetes in Farmer’s lung
It is a type II hypersensitivity. Slide 15
What is the clinical presentation of acute hypersensitivity pneumonitis and the treatment?
Cough, breathless, fever, myalgia
Crackles but no wheeze
On a CXR there is a wide spread of pulmonary infiltrates
Treatment: O2, steroids and antigen avoidance. Slide 16
What is the clinical presentation of chronic hypersensitivity pneumonitis and the treatment?
Progressive breathlessness and cough
Crackles and pulmonary fibrosis on CXR
Treatment: remove antigen, oral steroids or low gas transfer. Slide 17
What is idiopathic pulmonary fibrosis?
Scarring of the lung tissue due to inbalance of fibrotic repair and is not inflammatory. Slide 19
What is the clinical presentation of IPF and what is the characteristic image in a CT scan of it?
Progressive breathlessness, bilateral infiltrates, clubbing and bilateral inspiratory crackles.
The CT scan shows traction bronciectasis, honeycomb changes and fibrotic shadowing at peripherals. Slide 20
How can you treat IPF?
Since it is not inflammation, steroids and immunosuppressants wouldn’t work.
However antifibrotic drugs e.g. pirfenidone and nintedanib can be used but are very expensive.
O2 supplied if hypoxic. Slide 22
What is progressive massive fibrosis?
Dense fibrosis that can make complicated pneumonoconiosis worse in coal workers. Slide 29+30
What can a few asbestos fibres cause in the lungs?
Benign pleural plaques which are asymptomatic. Slide 32
