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The Respiratory System > Interstitial Lung Disease > Flashcards

Interstitial Lung Disease Flashcards

1
Q

What is interstitial lung disease?

A

Any diesase affecting the lung interstitium - the latter parts of the bronchial tree such as terminal bronchi and alveoli

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2
Q

Interstitial lung disease will _______ gas transfer in the lungs

A

Impair

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3
Q

Interstitial lung disease is a form of _________ lung disease

A

Restrictive

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4
Q

What is another name for interstitial lung disease?

A

Diffuse parenchymal lung disease (DPLD)

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5
Q

What are the three types of interstitial lung disease?

A
  1. Acute
  2. Episodic
  3. Chronic
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6
Q

What may be the causes for chronic interstitial lung disease?

A
  • Systemic disease
  • Log term allergen/inflammatory agent exposure
  • Idiopathic
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7
Q

What is sarcoidosis?

A

A condition caused by a hypersensitivity type IV reaction

It is a granuomatous disease involving non-caseating granuloma

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8
Q

Which interstitial lung condition is less common in smokers?

A

Sarcoidosis

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9
Q

What are the two types of sarcoidosis?

A
  1. Acute
  2. Chronic
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10
Q

Acute sarcoidosis may have signs and symptoms including what?

A
  • Erythema nodosum - inflammation of fat cells under the skin giving a red blotchy appearance
  • Bilateral hilar lymphadenopathy - enlargement of lymph nodes arround the hila
  • Arthritis
  • Fever
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11
Q

Chronic sarcoidosis may have signs and symptoms inlcuding?

A
  • Lung infiltrates - alveolitis
  • Skin infiltrates - oedema
  • Peripheral lymphadenopathy
  • Hypercalcaemia - high calcium level in blood serum
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12
Q

How can sarcoidosis be diagnosed?

A
  • CXR
  • CT scans - can show peripheral nodular infiltrate
  • Tissue biopsies confirm presence pf non-caseating granulomatous tissue
  • Pulmonary function testing will show a restrictive pattern since there are lung infiltrates
  • Blood tests can show raised calcium and inflammatory cell levels
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13
Q

Differential diagnosis for sarcoidosis may include what?

A
  • Tb
  • Lymphoma
  • Carcinoma
  • Fungal infection
  • Hypersensitivity pneumonitis
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14
Q

How is sarcoidosis treated?

A

Usually acute sarcoidosis does not need treated by if it affects a major organ steroids can be used

Oral steroids and immunosuppression can be used to treat chronic chronic sarcoidosis

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15
Q

Which types of immunosuppression drugs will be used to treat chronic sarcoidosis?

A
  • if acute self limiting oral steriod if chronic

methotrexate, azathioprine Second line option
* Anti-TNF therapy

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16
Q

What is extrinsic allergic alveolitis also known as?

A

Hypersensitivity pneumonitis

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17
Q

What is extrinsic allergic alveolitis caused by?

A

Type III hypersensitivity reaction

This causes deposition of immune complexes around the body

18
Q

Which conditions can cause extrinsic allergic alveolitis?

A
  • Farmer’s lung
  • Malt worker’s lung
  • Bird fancier’s lung

Conditions that involve inhalation of a foreign pathogen

19
Q

What are the three types of extrinsic allergic alveolitis?

A
  1. Acute
  2. Chronic
  3. Episodic
20
Q

What symptoms will acute extrinsic allergic alveolitis involve?

A
  • Cough
  • Breathlessness
  • Fever
  • Myalgia

Can come on hours after exposure

21
Q

What signs are there for acute extrinsic allergic alveolitis?

A
  • Pyrexia
  • Crackles
  • Hypoxia
  • Widespread pulmonary infiltrates on CXR
22
Q

Describe chronic extrinsic allergic alveolitis

A

There is a low dose of allergen exposed over time leading to worseing breathlessness and cough

Lung crackles is the main sign and pulmonary fibrosis is common in the upper zones

23
Q

What is the treatent of chronic extrinsic allergic alveolitis?

A
  • Removal of antigen
  • Oral steroids
24
Q

How is chronic extrinsic allergic alveolitis diagnosed?

A
  • History
  • Precipitins (IgG antibodies to putative antigen)
  • Lung biopsy
25
Q

What can be heard upon auscultation at the lungs for idiopathic pulmonary fibrosis?

A

Fine inspiratory crackles

26
Q

What does a CXR show for pulmonary fibrosis?

A

Bilateral infiltrates

27
Q

A CT scan for pulmonary fibrosis shows what?

A
  • Reticulonodular fibrotic shawdowing worse at lung bases and periphery
  • Bronchiectasis
28
Q

How can idiopathic fibrosis be diagnosed?

A

A good history focussing on common allergen sources

29
Q

Damage of lung architecture in idiopathic fibrosis can lead to what?

A

Honeycombining

30
Q

Which two drugs have been shown to have an anti-fibrotic effect?

A
  • Pirfenidone
  • Nintedanib

(can only slow condition - not curative)

31
Q

Which treatment may be considered for young patients with idiopathic fibrosis?

A

Lung transplant

32
Q

What is pneumoconiosis?

A

Damage done to the lungs via inhalation of dust such as that in coal mines or asbestosis for example

33
Q

Simple pneumoconionis has what types of symptoms and how is it diagnosed?

A

There are no symptoms

Can be picked up on CXR

34
Q

What is complicated pneumoconiosis?

A

Disease following progression of fibrosis leading to restrictive pattern of lung disease and breathlessness

35
Q

Chronic bronchitis can become present when coal dust is combined with what?

A

Smoking

36
Q

What is silicosis?

A

A condition that occurs after long-term exposure to quarts in mining, glass or boiler works

A simple pneumoconiosis will develop and over time chronic silicosis can produce symptoms and pulmonary fibrosis

37
Q

How can asbestos be removed from the lungs?

A

It can’t be

38
Q

What types of pleural disease is associated with asbestos?

A
  • Benign pleural plaques - asymptomatic
  • Acute asbestos pleuritis - fever, pain, bloody pleural effusion
  • Pleural effusion and diffuse pleural thickening - restrictive impairment
  • Malignant mesothelioma - incurable pleural cancer, presents with chest pain and pleural effusion
39
Q

Why can asbestos not be cleared?

A

Macrophages attempt this but fail and enter the pleura to die

Pulmonary fibrosis or asbestosis is caused due to the long term exposure and has a restrictive defect

40
Q

Which condition will increase the likelihood of asbestosis manifestation?

A

Bronchial carcinoma

(via smoking)

41
Q

Caplan’s syndrome

A

Caplan’s syndrome is a rare medical condition that is characterized by the development of rheumatoid arthritis (RA) in people who have been exposed to coal dust

The Respiratory System (19 decks)

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