Interstitial Lung disease * Flashcards
Granulomatous ILD
Sarcoidosis
Inhalational ILD
Hypersensitivity Pneumonitis
Pneumoconiosis (Occupational)
Idiopathic ILD
Pulmonary Fibrosis (MC)
Connective Tissue ILD
RA
Scleroderma
What is the MC ILD
Pulmonary Fibrosis
What are the RF for Pulmonary Fibrosis
Old male smokers
Occupational
Methotrexate user
EBV/CMV
What are the presentations of Pulmonary fibrosis
Exertional dyspnoae
Dry cough
What is the pathology of pulmonary fibrosis
Progressive lung scarring = T1 resp fail
What type of resp fail is pulmonary fibrosis
T1 (Fibrosis so improper filling)
How is Pulmonary fibrosis Investigated
Spirometry = Restriction
FEV1/FVC >0.7 w/
High Resolution CT = Ground glass lungs and traction bronchiectasia
How would you describe the image of Pulmonary fibrosis on a chest CT
Ground glass
Traction Bronchiectasia
How would you manage Pulmonary Fibrosis
Smoking cessation and Vaccine
Pirfenidone / Nintendinir
Lung transplant
What medication can be given for pulmonary fibrosis
Pirfenidone / Nintendinir
What is Pneumoconiosis
Occupational ILD
What are the two causatives of Pneumoconiosis
Silicosis
Abestosis
How can silicosis cause pneumoconiosis
Inhale silicon dioxide = eggshell calcification @ hilar lymph nodes
How can Asbestosis cause pneumoconiosis
Inhale asbestos = affected pleura = Mesothelioma (T1 RF)
What is sarcoidosis
Idiopathic granulomatous ILD
What are the RF for sarcoidosis
Women
20-40
Afro caribbean
How does a patient present w/ Sarcoidosis
Fever and fatigue
Dry cough and dyspnoea
Uveitis
Lupus Pemio (Blue/red nodules on nose/cheeks)
What is Lupus Pemio
Blue-red nodules on nose and cheeks
-Found in Sarcoidosis
How is Sarcoidosis investigated
CXR =Bilateral hilar adenopathy and Pulmonary infiltrates
Biopsy = Non caseating granuloma
Raised Calcium and Serum ACE(Granuloma)
How is Sarcoidosis managed
Corticosteroids if Symptomatic
What is Hypersensitivity Pneumonitis
T3 Hypersensitivity (Antibody to antigen complex deposition) @lung tissue causing Immune hyperresponse
What are the RF for HS Pneumonitis
Occupation (Farming and bird keeping)
What causes farmer’s lung Pneumonitis
Mouldy Hay
What causes Pigeon Fancier’s lung in pneumonitis
Avian protein in bird droppings
How can HS Pneumonitis be managed
Removing the allergen
What is Good pasture’s Syndome
T2 Autoimmune HS reaction caused by Anti GBM
What is the pathology of GoodPastures
Anti GBM attacks lungs (fibrosis) and kidneys (GN)
How is Good Pastures Investigated
Lung and kidney biopsy for damage and IgA Deposition
Anti GBM positive
What antibody is produced in Good pastures
Anti GBM
How is Good pastures managed
Supportive
Corticosteroids
Plasma exchange (remove Anti GBM)
What is Wegener’s GPA
Granulomatosis w/ Polyangitis
-Small/Medium cell Vasculitis affecting ELK (ENT, Lung and Kidney)
What are the presentations of Wegener’s
ENT - Saddle nose and ear infection
Lungs = Diffuse Alveolar haemorrhage = Haemoptysia
Kidney = GN = Haematuria
How does Wegener’s affect the ENT
Saddle shaped nose and ear infection
How does Wegener’s affect the kidney
GN causing haematuria
How does Wegener’s affect the Lungs
Diffuse alveolar haemorrhage = Haemoptysia
What is the diagnostic serology for Wegener’s EGPA
cANCA
How can the serology of Wegeners GPA and MPA be differentiated
wGPA =cANCA
MPA = pANCA
How is Wegener’s GPA Treated
Corticosteroids
Rituximab for immunosuppressed
