Interstitial Lung Disease Flashcards
Which part of the lungs is effected in interstitial lung disease?
Alveoli/terminal bronchi
What are the clinical features of interstitial lung disease?
Restrictive lung pattern
SOB
Dry cough
Which hypersensitivity type is extrinsic allergic alveolitis (EAA)?
type 3 (can be type 4 if granulomas form)
What causes EAA?
Inhalation of allergens e.g. fungal spores, avian proteins
Give some examples of EAA
Bird/pigeon fancier’s lung
Farmer’s lung
Mushroom worker’s lung
Malt worker’s lung (aspergillosis)
Give some examples of drugs that can cause EAA
Gold Bleomycin Nitrofurantoin Sulphasalazine Methotrexate Rituximab
What are the acute features of EAA?
Fever Rigors Myalgia Dry cough SOB Crackles (no wheeze)
What is seen on CXR in chronic EAA?
Pulmonary fibrosis –> upper lobes
Honeycombing
Ground-glass appearance
What is the treatment for EAA?
Remove antigen exposure
Oral steroids
What is pneumoconiosis and give 3 examples?
Lung disease caused by inhalation of dust
- Coal worker’s pneumoconiosis
- Silicosis
- Asbestosis
What causes silicosis?
Inhalation of silica dust (found in rocks such as quartz)
What is the classic radiological feature in silicosis?
Eggshell calcification of hilarity lymph nodes
What are the radiological features of asbestosis?
Fibrosis + pleural thickening
What is Caplan’s syndrome?
Combination of seropositive rheumatoid arthritis and pneumoconiosis (fibrosis)
What is the most common interstitial lung disease?
Idiopathic pulmonary fibrosis
What is the pathophysiology of idiopathic pulmonary fibrosis?
Lungs lay down scar tissue even though there is no need for repair
Non-inflammatory (doesn’t respond to steroids)
What is seen on CT scan in idiopathic pulmonary fibrosis?
Reticulonodular fibrotic changes
Worst at lung bases
Which organs are most commonly affected in sarcoidosis?
Lungs
Skin
Eyes
What type of hypersensitivity is sarcoidosis?
Type 4 –> granulomatous
Who most commonly gets sarcoidosis?
Women aged 20-40
Afro-Caribbean
Non-smokers
What are some features of acute sarcoidosis?
Erythema nodosum Bilateral hilar lymphadenopathy Arthritis Uveitis Parotitis Fever (less lung involvement than when chronic)
What are some features of chronic sarcoidosis?
Lung infiltrates (alveolitis) Skin infiltrates e.g. lupus pernio Peripheral lymphadenopathy Hypercalcaemia Chronic fatigue
What is lupus pernio?
Skin plaques with discolouration of nose, cheeks, lips and ears
What would be seen on a CXR in someone with sarcoidosis?
Bilateral hilar lymphadenopathy + pulmonary infiltrates
