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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
What can be heard upon auscultation at the lungs for idiopathic pulmonary fibrosis?
Fine inspiratory crackles
26
What does a CXR show for pulmonary fibrosis?
Bilateral infiltrates
27
A CT scan for pulmonary fibrosis shows what?
* Reticulonodular fibrotic shawdowing worse at lung bases and periphery * Bronchiectasis
28
How can idiopathic fibrosis be diagnosed?
A good history focussing on common allergen sources
29
Damage of lung architecture in idiopathic fibrosis can lead to what?
Honeycombining
30
Which two drugs have been shown to have an anti-fibrotic effect?
* Pirfenidone * Nintedanib (can only slow condition - not curative)
31
Which treatment may be considered for young patients with idiopathic fibrosis?
Lung transplant
32
What is pneumoconiosis?
Damage done to the lungs via inhalation of dust such as that in coal mines or asbestosis for example
33
Simple pneumoconionis has what types of symptoms and how is it diagnosed?
There are no symptoms Can be picked up on CXR
34
What is complicated pneumoconiosis?
Disease following progression of fibrosis leading to restrictive pattern of lung disease and breathlessness
35
Chronic bronchitis can become present when coal dust is combined with what?
Smoking
36
What is silicosis?
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
How can asbestos be removed from the lungs?
It can't be
38
What types of pleural disease is associated with asbestos?
* 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
Why can asbestos not be cleared?
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
Which condition will increase the likelihood of asbestosis manifestation?
Bronchial carcinoma | (via smoking)
41
Caplan’s syndrome
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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