Interstitial Lung Disease Flashcards
what is interstitial lung disease
broad term used to describe diseases affecting the lung parenchyma causing inflammation + fibrosis
- Fibrosis is the replacement of normal lung tissue with scar tissue
- this is stiff and does not function properly – restrictive lung disease
causes of fibrosis predominantly affecting upper zones
extrinsic allergic pneumonitis
pneumoconiosis - coal workers lung, silicosis
sarcoidosis
TB
causes of fibrosis predominantly affecting lower zones
idiopathic pulmonary fibrosis
drug induced
asbestosis
SLE, RA, Vasculitis
drugs that can cause pulmonary fibrosis
BARMAN
Bleomycin Amiodarone Radiation Methotrexate Aspirin + ACEIs Nitrofurantoin
most common cause of interstitial lung disease
idiopathic pulmonary fibrosis
symptoms of idiopathic pulmonary fibrosis
dry cough
SOB
fatigue / arthralgia
weight loss
signs of idiopathic pulmonary fibrosis on examination
end inspiratory crackles
clubbing
appearance of idiopathic pulmonary fibrosis on CT scan
‘honeycombing’ of the lung
drugs used to slow progression of idiopathic pulmonary fibrosis
mean survival is 3 years
Pirfenidone / Nintedanib are licensed to slow progression
what type of reaction is extrinsic allergic alveolitis
type 3 hypersensitivity
- immune complex mediated
- occurs 4-8 hours after exposure to inhaled particles
what is the reaction to in
- Farmers lung
- Bird fanciers lung
- Malt workers lung
farmers lung = reaction to mouldy spores in hay (Actinomycetes bacteria)
bird fanciers lung = reaction to avian protein
malt workers lung = reaction to mould on barely (aspergillus clavatus)
presentation of extrinsic allergic alveolitis
SOB, dry cough, malaise, fever 4-8 hours after exposure
chronic
appearance of extrinsic allergic alveolitis on CT scan
ground glass appearance
bronchoalveolar lavage finding in extrinsic allergic alveolitis
lymphocytosis
management of extrinsic allergic alveolitis
avoidance of antigen
steroids + oxygen if required
