Interstitial Lung Disease Flashcards
What is Interstitial lung disease
Umbrella term for conditions that affect lung parenchyma causing inflammation and fibrosis
What is fibrosis
the replacement of normal elastic and functional tissue to scar tissue that is stiff
How is interstitial lung disease diagnosed
1- High resolution CT scan of thorax
2- lung biopsy is diagnosis is unclear
3- clinical features
How does interstitial lung disease appear on the HRCT
Ground glass appearance
Is the damage in interstitial lung disease reversible
No
What are the management options for interstitial lung disease ( Hint: 7 )
1- remove or treat underlying cause
2- home oxygen if hypoxic at rest
3- stop smoking
4- physiotherapy and pulmonary rehabilitation
5- pneumococcal and flu vaccine
6- advanced care planning and palliative care if appropriate
7- lung transplant
What is Idiopathic pulmonary fibrosis
Condition where there is progressive pulmonary fibrosis with no clear cause.
How does idiopathic pulmonary fibrosis present
1- insidious onset of SOB
2- dry cough over 3+ months
3- bibasal fine inspiratory crackles
4- finger clubbing
What is the prognosis of idiopathic pulmonary fibrosis
poor prognosis with 2-5 years for life expectancy
What medications are used to slow the progression of idiopathic pulmonary fibrosis and explain their purpose
1- Piefenidone : antifibrotic and anti inflammatory
2- Nintedanib : antibody targeting tyrosine kinase
What drugs can cause drug induced pulmonary fibrosis ( Hint : 4 )
1- Amiodarone
2- Cyclophosphamide
3- methotrexate
4- Nitrofurantoin
Secondary pulmonary fibrosis can occur secondary to what conditions ( Hint: 4 )
1- Alpha-1 antitripsin deficiency
2- Rheumatoid arthritis
3- Systemic lupus erythematosus ( SLE)
4- Systemic sclerosis
What is hypersensitivity pneumonitis
A type III hypersensitivity reaction to environment allergen that causes a parenchymal inflammation in patients sensitive to that allergen
What is Bronchoalveolar Lavage
Collecting cells from airways during bronchoscopy by washing airways with fluid and then collecting the fluid for testing
What does the bronchoalveolar lavage show in hypersensitivity pneumonitis
Raised lymphocytes and mast cells
What is the management of hypersensitivity pneumonitis
1- Removing of allergen
2- Oxygen
3- steroids
What are the different types of hypersensitivity pneumonitis ( Hint : 4 )
1- Bird-fanciers lung : bird droppings
2- Farmers lung : mouldy spores in hay
3- Mushroom workers’ lung : mushroom antigens
4- Malt workers lung : mould on barley
What is cryptogenic organizing pneumonia
A focal area of inflammation in the lung that is idiopathic or triggered by infection , inflammatory disorder , medications , radiation , or allergens
What is the presentation of cryptogenic organizing pneumonia ( Hint : 4 )
1- SOB
2- cough
3- fever
4- lethargy
How does cryptogenic organizing pneumonia present on chest X-ray
Focal consolidation
What is the definitive investigation for cryptogenic organizing pneumonia and why
Lung biopsy in order to differentiate it from infective pneumonia
What is the treatment of cryptogenic organizing pneumonia
Corticosteroids
What is Asbestosis
Lung fibrosis due to inhalation of asbestos
What does oncogenic mean
something that causes cancer
Is asbestos oncogenic or fibrogenic
It is Both
What problems does asbestos inhalation cause ( Hint : 4 )
1- Lung fibrosis
2- Pleural thickening and pleural plaques
3- Adenocarcinoma
4- Mesothelioma
