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Interstitial Lung Disease Flashcards

1
Q

What is ILD?

A

Any disease affecting lung interstinum- i.e terminal bronchioles, alveoli

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2
Q

What is the main effect of ILD on the lungs?

A

Impaired gas exchange

Reduced lung function, Restrictive pattern

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3
Q

Two most common symptoms of ILD?

A
  1. Breathlessness

2. Dry Cough

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4
Q

What are the four broad classifications of ILD?

A
  1. Known cause- drugs/ other disease
  2. Idiopathic interstitial pneumonia- idiopathic pulmonary fibrosis
  3. Granulomatous ILD’s- e.g. sarcoidosis
  4. Other forms
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5
Q

What type of hypersensitivity reaction is seen in Sarcoidosis?

A

Type 4- delayed

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6
Q

What is sarcoidosis?

A

Inflammation characterised by granuloma formation and lymphadenopathy.

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7
Q

Sarcoidosis can affect multiple systems such as commonly?

A

Lungs, lymph nodes, skin, liver

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8
Q

What are the signs of Acute sarcoidosis?

A
  1. Erythema nodosum
  2. Bilateral hilar lymphadenopathy
  3. arthritis
  4. Fever
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9
Q

What are the signs of chronic sarcoidosis?

A
  1. Lung infiltrates (alveolitis)
  2. Skin infiltrations
  3. Peripheral lymphadenopathy
  4. hypercalcaemia
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10
Q

What are some differential diagnoses for Sarcoidosis?

A
  • TB
  • Fungal infection
  • Lymphoma
  • Carcinoma
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11
Q

What is the treatment for acute sarcoidosis?

A

Usually self limiting doest need medication

Give steroid if vital organ affected

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12
Q

Treatment for chronic sarcoidosis?

A
  • Oral steroids

- Immunsuppression (methotrexate, anti TNF therapy)

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13
Q

What type of cells are found in a granuloma?

A
  1. Multinucleated giant cells
  2. Fibroblasts
  3. Plasma cells
  4. Collagen
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14
Q

What is EAA or hypersensitivity alveolitis?

A

Inflammation of the alveoli as an end result of Hypersensitivity reaction to an inhaled particle in the airways.

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15
Q

What type of hypersensitivity reaction is seen in EAA?

A

Type III

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16
Q

What are some etiological causes of EAA?

A
  1. Farmers lung
  2. Malt workers
  3. Mushroom workers
  4. Bird fanciers lung (avian antigen)
  5. Drugs (bleomycin, methotrexate)
17
Q

What are the signs and symptoms of acute EAA?

A

Symptoms

  • Cough
  • Breathlessness
  • Fever
  • Myalgia

Acute symptoms present Several hours after exposure

Signs
- Hypoxic
- Crackles (no wheeze)
+/- pyrexic

18
Q

What treatment should be given to acute EAA?

A

Oxygen, steroid, antigen avoidance

19
Q

Signs symptoms of chronic EAA?

A

Symptoms
Progressive cough and breathlessness

Signs
- Crackles, clubbing unusual
- CXR: Fibrosis especially at lung apices
- Restrictive lung pattern
Diagnosis- History Of exposure main aspect

20
Q

Treatment for chronic EAA?

A
  1. Remove Antigen exposure

2. Steroid

21
Q

What is idiopathic pulmonary fibrosis (IPF) ?

A

Fibrosis (scarring) of the alveolar walls causing honeycombing, due to unknown causes. A type of ILD

22
Q

What happens to the fibrotic repair system in IPF?

A

Imbalance, leading to fibrosis

23
Q

IPF is an inflammatory disease. T/F?

24
Q

What are some other diseases that can cause IPF?

A
  1. Rheumatoid arthritis
  2. SLE
  3. Systemic sclerosis
25
What kind of drugs can cause IPF?
1. Bleomycin 2. Gold 3. Methotrexate 4. Amiodarone
26
Two main symptoms of IPF?
PROGRESSIVE breathlessness and cough
27
Two examination findings in IPF?
1. Clubbing | 2. Fine bilateral inspiratory end crackles
28
What type of pattern is seen in Lung function tests in IPF?
Restrictive effect- low FEV1 & FVC , normal ratio reduced volumes
29
What CXR appearances are seen in IPF?
Bilateral infiltrates
30
What changes in a CT scan can diagnose IPF?
1. Reticulonodular fibrotic shadowing at bases & periphery 2. Traction Bronchiectasis 3. Honey combing
31
What are the differentials for IPF?
1. Occupational (asbestos, silicosis) 2. Connective tissue disease (Rha, SLE) 3. LVF 4. Sarcoidosis, EAA
32
Main forms of treatment for IPF?
1. Antifibrotics- Nintedanib, Pirfenidone 2. Steroids, Immunosuppressants 3. Oxygen if hypoxic
33
What is coal workers pneumoconiosis?
Inflammation of alveolar walls by alveolar macrophages in response to Dust (coal).
34
Coal workers pneumoconiosis impairs lung function. T/F
False. Diagnosis can be made from Occupational history and CXR
35
What chronic disease is Coal workers pneumoconiosis associated with?
COPD
36
What happens in complicated pneumoconiosis?
Progressie mass fibrosis and collagen deposition in air spaces= restrictive lung patterns
37
What happens in silicosis?
Similar process as above, caused by quartz exposure
38
What CXR change is seen in silicosis?
Egg shelled Calcificaton of hilar nodes
39
What disease is Asbestosis associated with?
Pleural disease at any stage 1. Benign pleural plaque- asymptomatic 2. Acute asbestos pleuritis- fever, chest pain, bloody effusion 3. Pleural effusion 4. Mesothelioma

RESP (25 decks)

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