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Respiratory > Interstitial Lung Disease & occupational lung diseases > Flashcards

Interstitial Lung Disease & occupational lung diseases Flashcards

1
Q

Which parts of the lung do ILDs effect?

A

the alveoil and terminal bronchi

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2
Q

How would ILDs appear on lung function tests?

A

reduced FVC
reduced FEV1
ratio normal

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3
Q

What is the most common type of ILD?

A

Idiopathic interstitial pneumonia (IIP)

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4
Q

What is the most common type of IIP?

A

Idiopathic pulmonary fibrosis (IPF)

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5
Q

what type of ILD is sarcoidosis?

A

Granulomatous interstitial lung disease

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6
Q

Sarcoidosis comes under which type of hypersensitivity disease?

A

Type 4

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7
Q

what is the cause of sarcoidosis?

A

there is no known cause

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8
Q

What group of people is sarcoidosis more prevalent in?

A

Afro-Caribbean’s

non-smokers

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9
Q

What organs are commonly effected by sarcoidosis?

A 
Lungs
lymph nodes
joints
liver
skin
eyes
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10
Q

what organs are less commonly effected by sarcoidosis?

A

kidneys
brain
heart
nerves

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11
Q

what would the histopathology of sarcoidosis be?

A

non-caeseating granulomas

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12
Q

Bilateral hilar lymphadenopathy, erythema nodosum, arthritis, fever and uveitis are characteristics of what ILD?

A

acute sarcoidosis

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13
Q

lung infiltrates. skin infiltrations, peripheral lymphadenopathy and hypercalcaemia are characteristics of what ILD?

A

chronic sarcoidosis

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14
Q

what would be in your differential diagnosis for sarcoidosis?

A

TB
lymphoma
carcinoma
fungal infection

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15
Q

what investigations would you carry out for suspected sarcoidosis?

A 
CXR
CT
Tissue biopsy
pulmonary function test
blood test (for ACE levels, calcium levels and inflammatory markers)
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16
Q

how would you treat acute sarcoidosis?

A

it’s usually self-limiting

oral steroids if it effects any vital organs

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17
Q

how would you treat chronic sarcoidosis?

A

oral steroids

immunosuppression: azathioprine, methotrexate, anti TNF therapy

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18
Q

what is another name for extrinsic allergic alveolitis?

A

hypersensitivity pneumonitis

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19
Q

what type of hypersensitivity does extrinsic allergic aveolitis come under?

A 
type 3 (immune complex deposition)
- lymphocytic alveolitis
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20
Q

what antigens can predispose you to extrinsic allergic alveolitis?

A 
Thermophilic actinomycetes (farmers lung, malt workers etc.)
Avian antigens (bird fanciers lung)
Drugs (gold, bleomycin, suphasalazine)
21
Q

what is the classical presentation of acute extrinsic allergic alveolitis?
what would their signs on examination be?

A

Flu-like symptoms (cough, SOB, fever, myalgia) a few hours after antigen exposure
pyrexia, crackles (NO WHEEZE), hypoxia

22
Q

what would you see on a CXR of someone with acute extrinsic allergic alveolitis?

A

widespread pulmonary infiltrates

23
Q

how would you treat extrinsic allergic alveolitis?

A

O2 if hypoxic
steroid
antigen avoidance

24
Q

how would chronic extrinsic allergic alveolitis present?

clinical examination findings?

A

progressive cough and breathlessness over years

crackles, sometimes clubbing (unusual though)

25
Q

what would you see on a CXR of someone with chronic extrinsic allergic alveolitis?

A

pulmonary fibrosis, particularly in the upper zones

26
Q

how would you diagnose extrinsic allergic alveolitis?

A

detailed history of exposure
percipitins (IgG antibody testing)
if in doubt- lung biopsy

27
Q

Idiopathic pulmonary fibrosis is an inflammatory disease. true or false?

A

false

28
Q

what are some drugs that may be a secondary cause of IPF?

A 
aminodarone
busulphan
bleomycin
penicillamine
nitrofurantoin
methotrexate
29
Q

how does idiopathic pulmonary fibrosis present?

A

progressive SOB over years

dry cough

30
Q

bilateral fine inspiratory crackles and digital clubbing are signs of which ILD?

A

idiopathic pulmonary fibrosis

31
Q

what investigations would you carry out for IPF?

A

lung function test
CXR
CT
transbronchial/ thorascopic lung biopsy (if CT undiagnostic)

32
Q

what would you see on a CT scan of someone with idiopathic pulmonary fibrosis?

A

reticulonodular fibrotic shadowing (at bases and peripherals)
traction bronchiectasis
honey-combing

33
Q

what would be differentials of IPF?

A 
occupational disease
connective tissue diseases
LV failure
sarcoidosis
extrinsic allergic alveolitis
34
Q

A pathology report of:
“usual interstitial pneumonia pattern, heterogenous fibrosis in alveolar walls with fibroblastic foci and destruction of archetecture (honey-combing). minimal inflammation” would indicate which ILD?

A

Idiopathic pulmonary fibrosis

35
Q

treatment for IPF includes steroids and immunosuppressants. true or false?

A

true.

however, these drugs will not change the course of the disease.

36
Q

Pirfenidone and Nintedanib are examples of which class of drug?

A

antifibrotic drugs

37
Q

when would a lung transplant be considered in IPF?

A

if the patient is young enough and has minimal comorbidities

38
Q

What is the difference between simple and complicated coal worker’s pneumoconiosis?

A

simple only has an abnormality in CXR (lung functions are normal)
complicated has massive progressive fibrosis, restrictive lung function and SOB

39
Q

inhaling coal dust if you’re a smoker increases your risk of developing what?

A

chronic bronchitis

40
Q

what is Caplan’s syndrome?

A

rheumatoid pneumoconitis (in pulmonary nodules)

41
Q

what are risk factors for silicosis?

A 
long term exposure to quartz:
mining
foundry workers
glass workers
boiler workers
42
Q

egg-shell calcification of hilar lymph nodes of CXR indicates which condition?

A

simple silicosis

43
Q

what would you expect to find in lung function tests and CXR in chronic silicosis?

A

restrictive lung function

pulmonary fibrosis

44
Q

what are the 4 main pleural diseases related to asbestos exposure (in progressively worse order)?

A

benign pleural plaques
acute asbestos pleurits
pleural effusion & diffuse pleural thickening
malignant mesothelioma

45
Q

fever, pain, bloody pleural effusion indicates with asbestos related disease?

A

acute asbestos pleurtis

46
Q

chest pain, pleural effusion, dyspnoea and weight loss indicates which asbestos related disease?

A

malignant mesothelioma

47
Q

how would pulmonary fibrosis “asbestosis” present?

A

diffuse pulmonary fibrosis
restrictive lung function
asbestos in sputum and in lung on biopsy

48
Q

smokers with asbestos exposure increase their risk of what?

A

bronchial carcinomas

Respiratory (19 decks)

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