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Respiratory > Interstitial lung disease > Flashcards

Interstitial lung disease Flashcards

1
Q

What is interstitial lung disease?

A

Any disease process affecting the lung interstitium i.e. the alveoli and terminal bronchi.

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2
Q

What kind of pattern does this produce on spirometry?

A

Restrictive. FVC will be reduced.

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3
Q

What kind of hypersensitivity reaction is sarcoidosis?

A

Type 4 hypersensitivity

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4
Q

What does type 4 hypersensitivity mean?

A

Delayed-type reactions i.e. T-cell mediated

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5
Q

What characterises sarcoidosis?

A

Multi-system involvement
Non-caseating granulomas
Unknown aetiology

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6
Q

What are some of the features of acute sarcoidosis?

A 
Erythema nodosum
Uveitis
Bilateral hilar lymphadenopathy
Arthritis
Fever
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7
Q

What are some of the features of chronic sarcoidosis?

A 
Lung infiltrates i.e. alveolitis
Skin infiltrations
Peripheral lymphadenopathy
Hypercalcaemia
Multi-system involvement e.g. renal, myocardial, neurological
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8
Q

What are some differential diagnoses of sarcoidosis?

A

TB
Lymphoma
Carcinoma
Fungal infection

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9
Q

How is the diagnosis of sarcoidosis made?

A 
CXR
Bronchoscopy
Biopsy
CT 
Spirometry
Blood test - calcium levels and inflammatory markers
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10
Q

What type of hypersensitivity reaction is extrinsic allergic alveolitis?

A

Type 3 hypersensitivity

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11
Q

What does type 3 hypersensitivity mean?

A

Immune complex mediated hypersensitivity i.e. involvement of antibodies

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12
Q

What kind of diseases does extrinsic allergic alveolitis include?

A

Bird fanciers lung
Malt workers lung
Farmers lung

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13
Q

What are some of the symptoms of acute extrinsic allergic alveolitis?

A 
Cough
Breathlessness
Myalgia
Pyrexia
Hypoxia
Crackles
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14
Q

When does the onset of symptoms of acute extrinsic allergic alveolitis tend to occur?

A

Several hours after exposure

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15
Q

What are some of the symptoms and signs of chronic extrinsic allergic alveolitis?

A

Progressive breathlessness and cough

Crackles

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16
Q

What abnormalities would you expect to see on CXR with suspected diagnosis of extrinsic allergic alveolitis?

A

Widespread pulmonary infiltrates/may have progressed to fibrosis, particularly in upper zones
Lung biopsy can be done if in doubt

17
Q

What is the treatment for EAA?

A

Removal of antigen
Oxygen in acute exacerbation
Steroids

18
Q

What is the clinical presentation of idiopathic pulmonary fibrosis?

A

Progressive breathlessness
Dry cough
Finger clubbing
Fine inspiratory crackles bilaterally

19
Q

What abnormalities would you expect to see on CXR in suspected diagnosis of idiopathic pulmonary fibrosis?

A

Bilateral infiltrates

20
Q

What kind of histological changes might you see in idiopathic pulmonary fibrosis?

A

Chronic inflammatory infiltrate i.e. neutrophils and fibrosis in alveolar walls and/or intra-alveolar macrophages

21
Q

What treatment is available for idiopathic pulmonary fibrosis?

A

Lung transplant indicated for younger patients

22
Q

Can idiopathic pulmonary fibrosis result in death?

A

Yes - death within roughly five years due to type 1 respiratory failure

23
Q

What are some of the features of coal workers pneumoconiosis?

A

Initially just a CXR abnormality
Progressive massive fibrosis
Restrictive lung pattern
Breathlessness

24
Q

What are (ex-)coal workers who smoke at particular risk of developing?

A

Chronic bronchitis

25
Q

What is Caplan’s syndrome?

A

Rheumatoid pneumoconiosis

26
Q

What is silicosis?

A

An interstitial lung disease which develops after 15-20 years exposure to quartz

27
Q

Which workers are particularly at risk of developing silicosis?

A

Coal miners
Glass workers
Boiler workers

28
Q

What is the characteristic appearance of silicosis on CXR?

A

“Egg-shell” appearance

29
Q

What are some complications of chronic silicosis?

A

Progressive breathlessness
Restrictive lung pattern
Pulmonary fibrosis

Respiratory (16 decks)

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