Interstitial Lung Disease Flashcards
What are the zones of the lung
Zones 1- Zone 3
what is Zone 1
alveloar pressure is greater than capillary thus collapsing it
what is Zone 2
above the LA the alveolar pressure > venous but not arterial
what is Zone 3
base, low alveolar pressure, higher vascular pressure, alveoli more compliant
what is pulmonary fibrosis
scarring of parenchyma
may be idiopathic, associated with post disease processes (scaring), substance exposure, radiation, or autoimmune causes
where in the lung can occupational lung disease affect the pulmonary system
rhinitis
sinusitis
reactive airway
COPD
malignancy
pleuritis
fibrosis
what is the most common type of pulmonary fibrosis
idiopathic pulmonary fibrosis
m/c in men and those >40yo
progressive d/o
what is idiopathic pulmonary fibrosis associated with
chronic inflammation (alveolitis)
- over production of connective tissue cells
- change in airspace with formation of honeycomb cysts
what type of cell is damaged in idiopathic pulmonary fibrosis
type 1 epithelial cells
and overgrowth type 2
does not allow for repair/regrowth of the damaged epithelium
what are signs/symptoms of idiopathic pulmonary fibrosis
DOE
Inspiratory crackles
decreased forced vital capacity
clubbing
what is pulmonary fibrosis associated with chronic exposure to inorganic dust particles
penumoconiosis
m/c associated with silica, asbestos, coal
what is the presentation of penumoconiosis
cough, dyspnea, diminished lung volume, can progress to hypoxemia
often associated with work related exposures
what is Black Lung disease
coal workers pneumoconiosis
m/c in patients who work > 20 years in coal mine
m/c in KY, WV, VA
what is the pathophysiology of CWP
coal dust enters alveoli
macrophages attack particles
inflammatory reaction with cytokine release
form nodules within alveoli
bronchiole dilates
airway will change shape
obstruction
what is the presentation of CWP
cough, progressive dyspnea, melanopysis (black), pulmonary HTN, RV failure
1/3 of miners smoke
what causes silicosis
inhalation of crystalline silica - found in sand, concrete, mortar, glass, pottery, bricks
what professions have the most exposure to asbestos
welders, ship builders, bricklayers, carpenters, plumers, painters, electricians, navy person, construction of old houses
what is the presentation of asbestosis
initially asymptomatic but progresses to SOB, nonproductive cough, fatigue, clubbing, crackles, cor pulmonale, decreased lung volumes, diminished diffusion capacity
What is a noncaseating granulomatous disease
sarcoidosis - marked accumulation of T lymphocytes and phagocytes -> granuloma formation
immune disorder - HLA gene
the formation of granuloma elsewhere with sarcoidosis can lead to
diabetes insipidus with involvement of hypothalamus
meningitis
uveitis
restrictive cardiomyopathy
hepatospelnomegaly
arthralgia
erythema nodosum
what is a parenchymal inflammation secondary to immune reaction to inhaled noxious stimuli
hypersensitivity pneumonitis
thought to be genetic predisposition
what are the more common hypersensitivity pneumonitis
farmers lung
bird fanciers disease
local outbreaks: construction, ventilation or water contamination, manufacturing
what is farms lung
most common subtype of hypersensitivity pneumonitis
m/c in humid areas
may be seasonal
exposure to fungi/molds, yeast, mites, animal dust, excrement, chemical
What is bird fancier’s disease
seen in pigeon breeders - in this population, rates higher than in farmers
associated with handling of bird stool or material on feathers
what can reduce your risk of hypersensitivity pnneumonitis
smoking
define hypoxemia
decreased O2 in arterial blood
define hypoxia
decreased O2 in tissues
what is the cause of clubbing
result of chronic hypoxemia
m/c results from CHF, TB, interstitial pulmonary fibrosis, cyanotic congenital heart disease
