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OS 213 Respiratory Exam 2 > Interstitial Lung disease > Flashcards

Interstitial Lung disease Flashcards

1
Q

interstitial lung disease

A

radiologically diffuse infiltrates
histologically by distortion of the gas exchanging units
Physiologically by restriction of lung volumes and impaired oxygenation

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2
Q

Implies that the inflammatory process is limited specifically to the area between the alveolar epithelial and capillary endothelial basement membrane

A

interstitial

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3
Q

Common features of ILD (HISTORY)

A

Chronic non productive cough

Progressive exertional dyspnea

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4
Q

Common features of ILD (PE)

A

tachypnea +/- respiratory distress
cyanosis and clubbing
Bibasilar inspiratory crackles

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5
Q

Common features of ILD (Imaging)

A

Intestitial pattern

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6
Q

Common features of ILD (PFTs)

A

Restrictive pattern

DLCo Reduced

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7
Q

Suspect CTD in ILD if

A 
MSK Pain
Weakness
Fatigue
Joint pains and swelling
Photosensitivity
Raynauds Phenomenon
Pleuritis
Dry Eyes or mouth
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8
Q

Drug induced ILD

A 
Antibiotics (Nitro, sulfasalazine)
Anti-Inflam (Aspirin)
Chemotherapeutic
Miscellaneous
Illicit drugs
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9
Q

Silicates

A 
Silicosis
ASbestosis
Talcosis
Hydrated aluminum silicate
Fuller's earth
Nepheline
Aluminum silicates
Portland cement
Mica
Beryllium
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10
Q

Carbon

A

Coal dust (“coal worker’s pneumoconiosis”)

Graphite (“carbon pneumoconiosis”)

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11
Q

Metals

A 
Tin (Stannosis)
Aluminum
Hard metal dusts
Iron(siderosis, arc welder's lung)
Antimony
Hematite
Mixed dusts
Barium poweder
CuSO4
Rare eaths
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12
Q

Inhaled organic dusts

A

Hypersensitivity pnemonitis

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13
Q

Chemical sources

A

Synthetic fiber lung
Bakelite worker’s lung
Vinyl chloride, polyvinyl chloride powder

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14
Q

gases

A 
Oxygen
Oxides of nitrogen
SO2
Chlorine gas
Methyl isocyanate
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15
Q

Fumes

A

Oxides of zinc, copper, manganese, cadmium, iron, magnesium, brass, selenium, tin and antimony

Diphenylmethane diisocyanate

Trimellitic anhydride toxicity

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16
Q

Vapors

A

Hydrocarbons
Thermosetting resins
Toluene diisocyanate
Mercury

17
Q

Environmental sampling

A

Detector tubes
Indoor air quality sampling
Gas chromatography
Dust Sampling

18
Q

Coined by zenker in 1867 to denote changes in the lungs caused by retention of inhaled dusts.

A

Pneumoconiosis

19
Q

Management of ILD

A

No specific treatment is available

Therapy is directed largely at the complications of the disease

20
Q

A diffuse intestitial fibrosis of the lung resulting from inhalation and retention of considerable numbers of asbestos fibers, usually after prolonged exposure

A

Asbestosis

21
Q

CXR Asbestosis

A

Irregular small opacities in lower lung fields

22
Q

Indicator of asbestos exposure

A

Asbestos-related pleural plaques

  • most common manifestation of inhalation, retention and biologic effects
23
Q

Duration of ILD prior to diagnosis

A

Acute <3 weeks
SubAcute 3-12 weeks
Chronic >12 weeks

24
Q

Ausculation of ILD

A

velcro rales

25
Q

Typical HRCY Findings

A 
Bilateral (rarely unilateral)
Lower Lobe predominance
Sub-pleural reticular abnormalities
Minimal or no ground-glass changes
Honeycombing
Traction bronchiectasis
26
Q

A key element in the diagnosis of some ILDs

A

Lung biopsy

27
Q

Indications of lung biopsy

A

to assess disease activity
To exclude neoplasm or infection
to identify a more treatable condition
to establish a definitive Dx before starting a treatment with serious side effects
To provide a specific diagnosis in patients with
(Atypically or progressive pattern, a normal or atypical chest x-ray features)

28
Q

Relative contradications for lung biopsy

A

honey combing or evidence of end stage disease

Severe pulmonary dysfunction

Major operative risk

29
Q

Bronchoscopy

A

It is often initial procedure of choice

30
Q

Endobronchial lesions

A

Sarcoidosis

Wegener’s granulomatosis

31
Q

Inflammation and structure of the major airways

A

Wegener’s granulomatosis

32
Q

Surgical Biopsy

A

Video-assisted thoracoscopic lung biopsy is the preferred method of obtaining lung tissue

OS 213 Respiratory Exam 2 (15 decks)

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