Interstitial Lung Disease Flashcards
What are interstitial Lung Diseases?
any disease process that affects the Lung interstitium
Classic symptoms of ILD?
breathlessness
dry cough
Granulomatous, type IV hypersensitivity disease of unknown cause
Sarcoidosis
Common system involvement of Sarcoidosis
lungs, lymph nodes, joints, liver, skin, eyes
What type of granuloma is found in the lung of sarcoid patients?
non-caseating
Acute sarcoidosis is ____-_______
self-limiting
Symptoms of acute sarcoidosis
erythema nodosim bilateral hilar lymphadenopathy arthritis UVeitis Parotitis Fever
signs of chronic sarcoidosis
lung infiltrates
skin infiltrates
peripheral lymphadenopathy
hypercalcaemia
DDx with Sarcoidosis
TB, lymphoma, carcinoma, fungal infection
Investigations where sarcoidosis is suspect
CXR CT Biopsy Pulmonary function Blood test
Expected sarcoidosis findings in CXR
Bihilar lymphadenopathy
Expected sarcoidosis findings in CT
peripheral nodular infiltrates
Expected sarcoidosis findings in biopsy
non-caseating granuloma if anything
Expected sarcoidosis findings in pulmonary function tests
restrictive defect
breathlessness
reduction in blood gas levels
Blood test results in sarcoidosis
raised ACE
raised Calcium
raised, LFTs, CRP, Kidney
Treatment for acute sarcoidosis
let it settle itself
treatment for chronic sarcoidosis
oral steroids
if vital organs affected, immunosuppression (azathioprine, methotrexate, anti-TNF)
Type III hypersensitivity reaction to antigen
Extrinsic allergic alveolitis - hypersensitivity pneumonitis
Acute symptoms of extrinsic allergic alveolitis
cough, breathless, fever, myalgia, +/- pyrexia, +/- crackles, hypoxia
time frame for extrinsic allergic alveolitis symptoms
several hours after exposure
CXR results for acute allergic alveolitis
widespread pulmonary infiltrates
Treatment for acute extrinsic allergic alveolitis
oxygen, steroid and antigen avoidance
Chronic alveolitis presents with _____
progressive breathlessness and a cough
Signs of chronic extrinsic allergic alveolitis
crackles, clubbing is unusual
CXR signs of chronic extrinsic allergic alveolitis
pulmonary fibrosis, mostly in the upper zones
PFT signs of chronic extrinsic allergic alveolitis
restrictive defect, low FEV1/FVC, high or normal ratio, low gas transfer
Diagnosis of extrinsic allergic alveolitis
history, exam, lung biopsy, ask about the pets
Treatment for chronic extrinsic allergic alveolitis
remove antigen exposure, oral steroids if breathless or low gas transfer
