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Week 8 - Respiratory > Interstitial lung disease > Flashcards

Interstitial lung disease Flashcards

1
Q

What is sarcoidosis?

A
  • A multisystem inflammatory disease of unknown aetiology that predominantly affects the lungs and intrathroracic lymph nodes
  • It is characterised by non-necrotising granulomatous inflammation
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2
Q

What is the presentation of sarcoidosis?

A 
•Approx. 5% asymptomatic 
•Presentation is dependent on the extent and severity of the organ involved 
•Systemic symptoms in approx 45%: 
 - fever 
 - anorexia
 - fatigue 
 - night sweats
 - weight loss
 - chest pain 
 - cough and breathlessness 
 - rare = haemoptysis
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3
Q

What are the clinical signs of sarcoidosis?

A
  • Pulmonary findings
  • Dermatological manifestations - nodules
  • Ocular manifestation
  • Cardiac manifestation - may hear a rub
  • Neurologic manifestations
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4
Q

What are the lung signs of sarcoidosis?

A
  • Dyspnoea
  • Cough
  • Vague chest discomfort
  • Wheezing
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5
Q

Explain the stages of sarcoidosis from x ray

A
  • Represent radiogrpahic patterns
  • Do not indicate disease severity or changes in pulmonary function
  • 4 stages
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6
Q

Stage 1 sarcoidosis

A

Bilateral hilar lymphadenopathy without infiltration

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7
Q

Stage 2 sarcoidosis

A

Bilateral hilar lymphadenopathy with infiltration

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8
Q

Stage 3 sarcoidosis

A

Infiltration alone

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9
Q

Stage 4 sarcoidosis

A
  • Fibrotic bands
  • Bullae
  • Hilar retraction
  • Bronchiectasis
  • Diaphragmatic tenting
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10
Q

What is idiopathic pulmonary fibrosis the clinical manifestation of?

A

Usual interstitial pneumonia

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11
Q

How many lobes does the left lung have?

A

2

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12
Q

What are the signs and symptoms of idiopathic pulmonary fibrosis?

A
  • Progressive breathlessness (worse with exercise)
  • Bibasilar crackles
  • Peripheral interstitial pattern
  • fatigue and weakness
  • Apetite and weight loss
  • Clubbing
  • Hacking dry cough
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13
Q

What are the top 6 causes of pulmonary fibrosis?•

A
  • Occupational and environmental
  • Drug induced
  • Connective tissue disorders
  • Primary disease
  • Idiopathic
  • Genetic
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14
Q

Which drugs can cause pulmonary fibrosis?

A
  • Amiodarone
  • Nitrofurantoin
  • Methotrexate
  • Cocaine
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15
Q

What connective tissue diseases cause pulmonary fibrosis?

A
  • Lupus
  • Rheumatoid arthritis
  • Scleroderma
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16
Q

Which primary diseases cause pulmonary fibrosis?

A
  • Sarcoidosis

* LAM

17
Q

How can you diagnose pulmonary fibrosis?

A

•HRCT
•If difficult to diagnose: Video-assisted thorascopic surgery (VATS)
- 3 biopsies

18
Q

What is extrinsic allergic alveolitis?

A
  • Immunologically mediated inflammatory reaction in the alveoli and in the respiratory bronchioles
  • T cell mediated response
19
Q

What are the causes of Extrinsic allergic alveolitis?

A
  • Organic dusts
  • Moulds
  • Foreign proteins
  • Some chemicals
20
Q

Give 3 examples of EAA

A
  • Farmers lung - mouldy hay
  • Cheese washers lung - penicillium casei
  • Suberosis - cork dust mould
21
Q

What are the symptoms of EAA?

A
  • Flu like illness
  • Cough
  • High fever
  • Chills
  • Dyspnoea
  • Chest tightness
  • Malaise
  • Myalgia
22
Q

What are the symptoms of chronic EAA?

A
  • Dyspnoea in strain
  • Sputum production
  • Fatigue
  • anorexia
  • Weight loss
23
Q

What is the appearance of acute HSP on chest x ray?

A
  • numerous poorly defined small opacities thought both of the lungs
  • Sometimes sparing of the apices and bases
  • Airspace disease: usually seen as ground glass opacities
  • Fine reticulation may occur
  • Zonal distribution
24
Q

Describe the pathology of chronic HSP

A
  • Bronchiolocentric pattern
  • NNGI
  • Foamy macrophages in alveolar spaces
  • Chronic interstitial inflammation
  • Organising pneumonia

Week 8 - Respiratory (12 decks)

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