Interstitial Lung Disease Flashcards
What is ILD
Umbrella term to describe conditions which affect the lung parenchyma causing inflammation and fibrosis
Diagnosis of ILD
Combination of clinical features and high resolution CT scan of the thorax
What does a high resolution CT scan show
Ground glass appearance with ILD
Management of ILD
Poor prognosis and limited management as damage is irreversible
Types of ILD
Idiopathic pulmonary fibrosis, drug induced pulmonary fibrosis, secondary pulmonary fibrosis, hypersensitivity penumonitis, cryptogenic organising pneumonia, asbestosis
What is idiopathic pulmonary fibrosis
Progressive pulmonary fibrosis with no clear cause
Presentation of idiopathic pulmonary fibrosis
Insidious onset SOB and dry cough over more than 3 months
Examination of patient with idiopathic pulmonary fibrosis
Bibasal fine inspiratory crackles and finger clubbing
Medications which can slow the progression of idiopathic pulmonary fibrosis
Pirfenidone and Nintedanib
Drugs which can cause pulmonary fibrosis
Amiodarone, Cyclophosphamide, Methotrexate and Nitrofurantoin
Conditions which can cause secondary pulmonary fibrosis
Alpha-1 antitripsin deficiency, rheumatoid arthritis, SLE, systemic sclerosis
What is hypersensitivity pneumonitis
Type 3 hypersensitivity reaction to an environmental allegen which causes parenchymal inflammation
What does bronchoalveolar lavage involve
Collecting cells from the airways during bronchoscopy by washing the airways with fluid then collecting that fluid for testing
What will bronchoalveolar lavage show
Raised lymphocytes and mast cells
Management of hypersensitivity pneumonitis
Removing allergen, giving oxygen where necessary and steroids
Examples of specific causes of hypersensitivity pneumonitis
Bird-fanciers lung, Farmers lung, Mushroom workers lung, Malt workers lung
What is cryptogenic organising pneumonia
Focal area of inflammation of the lung tissue.
Cause of cryptogenic organising pneumonia
Idiopathic or triggered by infection, inflammation disorders, medications, radiation, or environmental toxins or allergens
Presentation of cryptogenic organising pneumonia
SOB, cough, fever, lethargy, focal consolidation
Treatment of cryptogenic organising pneumonia
Systemic corticosteroids
What problems can asbestos inhalation cause
Lung fibrosis, pleural thickening, pleural plaques, adenocarcinoma, mesothelioma
Causes of pulmonary fibrosis
Lung damage, irritants, diffuse parenchymal lung disease, connective tissue disease, medications and hypersensitivity pneumonitis
Symptoms of idiopathic lung fibrosis
Dry cough, SOB, fatigue, arthralgia, cyanosis, clubbing, crackles
Complications of pulmonary fibrosis
Type 2 respiratory failure, increased risk of lung cancer, cor pulmonale, mortality
Imaging results of pulmonary fibrosis
Bilateral lower zone reticulo-nodular shaddowing, honeycomb lung on CT
Management of pulmonary fibrosis
Pulmonary rehab, LTOT, antibiotics, control of RHF, long transplant
