L03: Suppurative And Fibrotic Lung Disease

Question 1

What is fibrotic lung disease

Answer 1

A disease that consists of inflammation and fibrosis of the lung parenchyma

Question 2

What is suppurative lung disease

Answer 2

Disease that results in chronic lung infection and pus production

Question 3

What are examples of suppurative lung disease

Answer 3

Bronchiectasis
Cystic fibrosis
Primary ciliary dyskinesia
Lung absces
Empyema

Question 4

What are the symptoms of fibrotic lung disease (intersitital lung disease)

Answer 4

Sob
Cough
Fatigue
Weakness
Fever
Joint pain and swelling

Question 5

What are the invesitgations carried out for interstitial lung disease

Answer 5

Cxr
High resolution ct scan
Lung function test

Question 6

What does a ct scan show for intersitial lung disease

Answer 6

Honeycombing and ground glass apperance

Question 7

What is the treatment for intersitital lung disease

Answer 7

Treat the cause
Oxygen
Prednisolne
Immunosupression
Anti fibrotic agent: pirfenidone and nintedanib

Question 8

What is a suppurative lung disease

Answer 8

Chronic lung infection and pus production e.g bronchiectasis and cystic fibrosis

Question 9

What is bronchiectasis

Answer 9

Permanent dilatation of bronchi due to recurrent infection and inflammation

Question 10

What is the cycle of inflammation and infection

Answer 10

1. Inflammation leads to damage to the cilia, elastic tissue and muscular tissue
2. There is reduced mucociliary clearance
3. This leads to excessive mucus production
4. The mucus encourages microbial growth leading to infection

Question 11

What are the causes of bronchiectasis

Answer 11

Idiopathic
Post infection
Tumour, foreign body
Poor muscular ciliary clearance: cystic fibrosis

Question 12

What are the clincal features of bronchiectasis

Answer 12

Chronic cough- months to years
Sob
Fatigue
Hemoptysis
Coarse crackles
Wheeze
Clubbing

Question 13

What investigations can be carried out for bronchiectasis

Answer 13

Blood test
Sputum trst
Cystic fibrosis sweat test
Cxr
Ct scan

Question 14

What will a chest xray for bronchiectasis show

Answer 14

Tram lines (thick dilated wall of bronchi)

Question 15

What does a ct scan show for bronchiectasis

Answer 15

Signet ring (large bronchi that are larger than arteries)

Question 16

What is the management of bronchiectasis

Answer 16

Exercise rehabilitation 
Airway clearnace technique
Nebulised saline
Culture sputum
Prophylactic antibiotics

Question 17

What will an acute exacerbation of bronchiectasis show

Answer 17

Increased cough
Sputum volume
Breatheless
Haemoptysis 
- over 48 hours

Question 18

What is the treatment for acute exacerbation of bronchiectasis

Answer 18

Oxygen

Antibiotics

Question 19

What is cystic fibrosis

Answer 19

An autosomal recessice disease where there is an impaired CTFR gene that results in CTFR protein abnormality

Question 20

What is the normal role of a ctfr protein

Answer 20

To secrease sweat, mucus, salive and digestive secretion

Question 21

When CTFR protien is abnormal what happens

Answer 21

Chloride ions cant be pumped into the airway and water cant follow so the airwat has mucus that is thick

Question 22

What are the other location apart from the respiratory tract where mucus can become plugged due to the ctfr protein abnormality

Answer 22

pancreatic duct

Bile duct

Question 23

What are the features of cystic fibrosis

Answer 23

Respiratory symptoms 
Failue to thrive in childhood
Thickened respiratory symptoms 
Rhinosinusitis
Mucus plugggin leading to bronchiectasis
Pancreastic exocrine insufficiency 
Glucose intolerance and diabetes
Hepatobiliary disease
Inferitiltiy

Question 24

What are the investigations for cystic fibrosis

Answer 24

heal prick test- in new born
Sweat test
Dna test- ctfr gene mutations

Question 25

What is the management of ctf

Answer 25

By a multi displinary approach

Question 26

What is the gold standard diagnostic test for bronchiectasis

Answer 26

Ct scan