Interstitial Lung Disease Flashcards
Interstitial Lung Disease
Any disease affecting lung interstitium
Interferes with gas transfer
Restrictive lung pattern
Symptoms of InterstitIal Lung Disease
Breathlessness
Dry cough
Biopsies
Transbronchial
Thorascopic
Sacroidosis
Type 4
Granulomatous
Non-caseating granuloma of unknown aetiology
Less common in smokers
Sarcoidosis Incidence
10-20/100,000
Commonly affected areas with sarcoidosis
Lungs, lymph nodes, joints, liver, skin, eyes
Less common affected areas by sarcoidosis
Kidneys, brain, nerves heart
Acute Sarcoidosis
Erythema Nodosum Bilateral Hilar Lymphadenopathy Arthritis Uveitis, partotits Fever
Chronic Sarcoidosis
Lung infiltrates
Skin Infliltrates
Peripheral lymphadenopathy
Hypercalcaemia
Sarcoidosis Investigations
CXR - Bilateral Hilar Lymphadenopathy CT - peripheral nodular infiltrate Tissue Biopsy Pulmonary function test (Restrictive) Blood test (ACE, Ca+, inflammatory markers)
Treatment of acute sarcoidosis
None
Treatment of chronic sarcoidosis
Oral steroids needed
Immunosupression
Hypersensitivity Pneumonitis
Type III
Reaction to antigen lymphocytic alveolitis
Acute Hypersensitivity Pneumonitis
Cough, breathlessness, fever, myalgia
Pyrexia, crackles, hypoxia
CXR = wide spread pulmonary inflitrates
Treatment of acute hypersensitivity pneumonitis
Oxygen, steroid and antigen avoidance
Chronic Hypersensitivity Pneumonitis
Repeated low dose exposure over time Progressive breathlessness and cough Crackles CXR = Pulmonary Fibrosis Pulmonary Function = restrictive
Treatment of Chronic Hypersensitivity Pneumonitis
Remove antigen exposure
Oral steroids if breathless or low gras transfer
Idiopathic Pulmonary Fibrosis
Most common interstitial lung disease Progressive breathlessness, dry cough Clubbing, bilateral fine inspiratory crackles CXR = bilateral infiltrates CT = reticulondular fibrotic shadowing
Simple Pneumoconiosis
CXR abnormality only
No impairment of lung function
Complicated pneumoconiosis
Progressive massive fibrosis (restrictive)
Caplans syndrome
Rheumatoid pneumoconiosis
Silicosis
15-20 years exposure to Quartz
CXR = egg shell calcification of hilar nodes
Asbestos
Mining, construction
Pleural disease:
1. Benign pleural plaques - asymptomatic
2. Acute asbestos pleuritis - fever, pain, bloody pleural effusion
3. Pleural Effusion and Diffuse Pleural Thickening - restrictive impairment
4. Malignant mesothelioma - fatal