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Y4 Resp > Interstitial Lung disease > Flashcards

Interstitial Lung disease Flashcards

1
Q

what are the two key symptoms of interstitial lung disease?

A

dyspnoea

dry cough

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2
Q

what medication can cause interstitial lung disease?

A 
bleomycin 
busulfan 
amiodarone 
nitrofurantoin 
sulfasalazine 
methotrexate 
methysergide
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3
Q

other than medication what else can cause interstitial lung disease?

A

asbestosis, silicosis

hypersensivity pneumonitis

TB, viral, fungal infections

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4
Q

what systemic disease is interstitial lung disease associated with?

A 
sarcoidosis 
RA
SLE
systemic sclerosis 
sjogrens 
MCTD (mixed connective tissue disease - lupus, scleroderma and polymyositis)
UC
ankylosing spondylitis
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5
Q

what causes upper lobe interstitial lung disease ?

A 
Aspergillosis : ABPA
Pneumoconiosis: Coal, Silica
Hypersensitivity pneumonitis 
Negative, sero-arthropathy
TB
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6
Q

what causes lower lobe interstitial lung disease ?

A 
Sarcoidosis (mid zone)
Medication 
Asbestosis
Idiopathic pulmonary fibrosis
Rheum: RA, SLE, Scleroderma, Sjogren’s, PM/DM
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7
Q

what type of hypersensivity reaction occurs in hypersensivity pneumonitis

A

Type 3 and 4

type 4 - granuloma formation and obliterative bronchiolitis

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8
Q

state three causes of hypersensivity pneumonitis ?

A

􏰀 Bird fancier’s lung: proteins in bird droppings

􏰀 Farmer’s / mushroom worker’s

􏰀 Malt worker’s lung: Aspergillus clavatus

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9
Q

what is the acute presentation of hypersensivity pneumonitis ?

A

fever, dry cough, malaise, dyspnoea, crackles

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10
Q

what is the chronic presentation of hypersensivity pneumonitis ?

A

increasing dyspnoea
wt loss
Type 1 resp failure
cor pulmonale

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11
Q

what are 4 histopathy features of hypersensivity pneumonitis ?

A

upper zone disease

foamy histiocytes

bronchiolitis obliterans

soft centracinar epitheloid granuloma

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12
Q

what investigations should be done for hypersensivity pneumonitis ?

A

Bloods
CXR
spirometry (restrictive)
bronchoalveolar lavage

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13
Q

what would bronchoalveolar lavage show for hypersensivity pneumonitis ?

A

↑ lymphocytes and mast cells

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14
Q

what appearance will the lung have on CXR with hypersensivity pneumonitis ?

A

honeycomb lung

fibrosis

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15
Q

what is the medical treatment for hypersensivity pneumonitis ?

A

avoid exposure

steroids (acute/long term)

compensation may be payable (UK industrial injuries Act)

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16
Q

what is another name for idiopathic pulmonary fibrosis ?

A

cryptogenic fibrosing alveolitis

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17
Q

what age and gender is most affected by idiopathic pulmonary fibrosis ?

A

middle age

males

18
Q

what is the commonest cause of interstitial lung disease?

A

idiopathic pulmonary fibrosis

19
Q

what are the symptoms of idiopathic pulmonary fibrosis ?

A 
dry cough 
dyspnoea
maliase
arthralgia 
obstructive sleep apnoea
20
Q

what are the signs of idiopathic pulmonary fibrosis ?

A

cyanosis
clubbing
crackles (fine, end inspiratory)

21
Q

what are the complications of idiopathic pulmonary fibrosis ?

A

increased risk of lung carcinoma
type 2 resp failure
cor pulmonale

22
Q

what antibodies can be positive with idiopathic pulmonary fibrosis ?

A

ANA (anti nuclear antibody) -30%

RF (rheumatoid factor) -10%

23
Q

would idiopathic pulmonary fibrosis have increased or decreased lung volume on CXR?

A

decreased lung volume due to fibrosis

24
Q

what imaging can be done for idiopathic pulmonary fibrosis after CXR?

A

high resolution CT

25
Q

what investigations can be done for idiopathic pulmonary fibrosis ?

A 
bloods (CRP, ANA, RF, ABG)
CXR
HRCT
spirometry 
lung biopsy 
bronchoalveolar lavage 
DTPA scan (may reflect disease activity)
26
Q

what is the management for idiopathic pulmonary fibrosis ?

A 
smoking cessation 
pulmonary rehabilitation 
O2 therapy 
anti-fibrotics (pirferidone, nitedanib)
surgery - lung transplant (only cure)
27
Q

what is 5YS for idiopathic pulmonary fibrosis ?

A

50%

28
Q

state three industrial lung diseases?

A

Coal-workers Pneumoconiosis

Silicosis

Asbestosis

29
Q

what work environment is associated with asbestosis ?

A

Demolition and ship building

30
Q

what does asbestosis increase the risk of?

A

mesothelioma

31
Q

what are the signs and symptoms of mesothelioma

A

Chest pain, wt. loss, clubbing, recurrent effusions, dyspnoea.

32
Q

how is a diagnosis of mesothelioma made?

A

pleural biopsy

33
Q

what is the average survival of asbestosis?

A

<2yrs

34
Q

what work environment is associated with silicosis ?

A

Quarrying, sand-blasting

35
Q

what does the CXR for Coal-workers Pneumoconiosis look like?

A

CXR: upper zone fibrotic masses

36
Q

what does the CXR for silicosis look like?

A

Upper zone reticular shadowing and egg shell

calcification of hilar nodes → progressive massive fibrosis

37
Q

what are 5 histopathological features of idiopathic pulmonary fibrosis ?

A

basal and posterior fibrosis

type 2 pneumocyte hyperplasia

proliferating fibroblastic foci

smooth muscle and vascular proliferation

evidence of new and old injury

38
Q

what is the biopsy of idiopathic pulmonary fibrosis described as?

A

usual interstitial pneumonitis

39
Q

What is the management of the industrial dust lung diseases? (Coal-workers Pneumoconiosis, silicosis and asbestosis)

A

avoid exposure

claim compensation from UK industrial injuries Act

40
Q

which industrial lung diseases can have the complication of progressive massive fibrosis ?

A

Coal-workers Pneumoconiosis

silicosis

41
Q

what are the three types of asbestosis ?

A

white (Chrysotile) - least fibrogenic

blue (Crocidolite) - most fibrogenic

brown (Amosite) - least common

42
Q

what chemo can be used for malignant mesothelioma ?

A

pemetrexed and cisplatin

Y4 Resp (17 decks)

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