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Medicine, Year 3, Cardiovascular and Respiratory Medicine > Interstitial Lung Disease > Flashcards

Interstitial Lung Disease Flashcards

1
Q

Which pneumocytes produce Surfactant in the lungs?

A

Type 2 Pneumocytes

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2
Q

State 4 Obstructive Respiratory Disorders

A

Asthma
Chronic Bronchitis
Emphysema
Bronchiectasis

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3
Q

State 4 Restrictive Respiratory Disorders

A 
Interstitial Lung Disease
- Idiopathic Pulmonary Fibrosis
- Sarcoidosis
- Pneumoconiosis
Chest Wall Neuromuscular Diseases
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4
Q

What is Pulmonary Fibrosis?

A

Infiltration of alveoli and lung interstitium by mesenchymal cells and increased amounts of ECM and collagen

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5
Q

Pulmonary Fibrosis can be associated with Connective tissue diseases. Give examples of 4

A
  • Rheumatoid Arthritis
  • Anonkylosing Spondylitis
  • Systemic Sclerosis
  • Dermatomyositis
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6
Q

What is the diagnostic test of choice for Pulmonary Fibrosis?

A

CT scan

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7
Q

How does the value of Transfer Factor change in patients with Pulmonary Fibrosis?

A

Reduced

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8
Q

Give 6 examples of conditions which commonly cause Upper Zone Fibrosis of the Lung? CHARTS

A 
C - Coal workers pneumoconiosis
H - Hypersensitivity pneumonitis / Histiocytosis
A - Ankylosing Spondylitis
R - Radiation
T - Tuberculosis
S - Silicosis / Sarcoidosis
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9
Q

Give example(s) of antibiotics which can cause Pulmonary Fibrosis

A

Nitrofuratoin

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10
Q

Give example(s) of chemotherapy agents which can cause Pulmonary Fibrosis

A

Bleomycin, Mitomycin, Cyclophosphamide, MTX

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11
Q

Give example(s) of anti-arrhythmic agents which can cause Pulmonary Fibrosis

A

Amiodarone

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12
Q

Give example(s) of DMARDs which can cause Pulmonary Fibrosis

A

Gold, SSZ

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13
Q

What may be visualised on CT in patients with Pulmonary Fibrosis?

A

Ground-glass appearance

Honeycombing

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14
Q

What clinical features in the hands may be associated with Pulmonary Fibrosis?

A

Clubbing

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15
Q

Hypersensitivity pneumonitis is a what type of Hypersensitivity reaction?

A

Type III (and Type IV) reaction

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16
Q

State six examples of Hypersensitivity Pneumonitis diseases

A 
Bird Fancier's Lung
Farmer's Lung
Mushroom Worker's Lung
Hot Tub Lung
Winemaker's Lung
Malt Worker's Lung
17
Q

Avian proteins are associated with which Hypersensitivity Pneumonitis?

A

Bird Fancier’s Lung

18
Q

Bird Fancier’s Lung is associated with which causative agent?

A

Avian proteins

19
Q

Mycobacterium avium are associated with which Hypersensitivity Pneumonitis?

A

Hot Tub Lung

20
Q

Saccharopolyspora Rectivirgula are associated with which Hypersensitivity Pneumonitis?

A

Farmer’s Lung

21
Q

Farmer’s Lung is associated with which causative agent?

A

Saccharopolyspora Rectivirgula

22
Q

Aspergillus Clavatus are associated with which Hypersensitivity Reaction?

A

Malt Worker’s Lung

23
Q

Malt Worker’s Lung is associated with which causative agent?

A

Aspergillus Clavatus

24
Q

Mushroom Worker’s Lung is associated with which causative agent?

A

Actinomycetes

25
Q

Actinomycetes is associated with which Hypersensitivity Reaction?

A

Mushroom Worker’s Lung

26
Q

Winemaker’s Lung is associated with which causative agent?

A

Botrytis Cinerea

27
Q

Botrytis Cinerea is associated with which Hypersensitivity Reaction?

A

Winemaker’s Lung

28
Q

What is the main treatment for Hypersensitivity Pneumonitis?

A

High dose corticosteroids

29
Q

What is Sarcoidosis?

A

A multisystem disorder of unknown aetiology characterised by non-caeseating inflammatory granulomas

30
Q

What are the features on X-Ray in a patient with Sarcoidosis?

A

Bilateral hilar lymphadenopathy

31
Q

What are the three skin / joint features associated with a patient with Sarcoidosis?

A

Erythema nodosum - raised bumps under skin
Lupus pernia - purple rash on nose
Polyarthalgia - painful joints

32
Q

What enzyme and electrolyte disturbance is associated with Sarcoidosis?

A

Raised ACE Levels

Hypercalcaemia

33
Q

Give 4 examples of conditions which can cause Lower Lung Fibrosis? MIDA

A

M - Most connective tissue disorders (Except Anonkylosing Spondylitis)
I - Idiopathic Pulmonary Fibrosis
D - Drug-induced Fibrosis
A - Asbestosis

34
Q

ASBESTOS

  1. What are some changes to the lungs associated with Asbestos?
  2. Are pleural plaques benign, pre-malignant or malignant?
  3. Where does Asbestosis typically occur?
  4. What is the most severe form of Asbestos causing mesothelioma?
  5. Features of mesothelioma?
  6. Diagnosis of mesothelioma?
A
  1. Pleural plaques, pleural thickening, asbestosis, mesothelioma
  2. Benign
  3. Lower zone
  4. Crocidolite (blue) form
  5. SOB, chest pain, pleural effusions
  6. Thoracoscopy, CT, CXR
35
Q

ALLERGIC BRONCHOPULMONARY ASPERGILLIOSIS

  1. What is it?
  2. What are the associated features?
  3. What is the management?
A
  1. ABA is due an allergy to Aspergillus spores
  2. Bronchiectasis, raised Eosinophils
  3. Glucocorticoids, then Itraconazole
36
Q

IDIOPATHIC PULMONARY FIBROSIS

  1. What is it?
  2. What are some symptoms?
  3. Main finding on auscultation?
  4. What are some investigations and findings on spirometry? Other investigations?
  5. What is the management?
A
  1. A chronic lung condition characterised by progressive fibrosis of the interstitium
  2. Progressive dyspnoea, dry cough, clubbing
  3. Bilateral fine end inspiratory crackles
  4. Spirometry: Restrictive picture with REDUCED TLCO, CT shows ground glass appearance
  5. Pulmonary rehab, Pirfenidone (anti-fibrotic), O2, lung transplant
37
Q

EXTRINSIC ALLERGIC ALVEOLIOLITIS

  1. What is EEA?
  2. What is Extrinsic Allergic Alveolitis also known as?
  3. What is Bird Fancier’s Lung caused by?
  4. What is Farmer’s Lung caused by?
  5. What is Malt Worker’s lung caused by?
  6. What is Mushroom Worker’s Lung caused by?
  7. Where does fibrosis typically occur?
  8. How is this different to Allergic Bronchopulmonary Aspergilliosis?
  9. What is the management?
A
  1. A condition caused by hypersensitivity induced lung damage due to a variety of inhaled organic particles
  2. Hypersensitivity Pneumonitis
  3. Avian protein
  4. Saccharopolyspora rectivirgula
  5. Aspergillus clavitus
  6. Actinomytes
  7. Upper / mid zones
  8. EEA = No eosinophillia. ABPA = eosinophillia
  9. Avoid trigger, glucocorticoids

Medicine, Year 3, Cardiovascular and Respiratory Medicine (19 decks)

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