Lung 2 Flashcards
diffuse interstitial/restrictive disease
diffuse, chronic involvement of pulmonary interstitum reducing FEV1 and FVC
wheezing in restrictive disease?
NO- only in obstruction
no obstruction in restrictive
cause of diffuse interstitial disease
inhalation of agents that cause inflammation and lead to permanent fibrosis
Fibrosing disorders
idiopathic pulmonary fibrosis/UIP
nonspecific interstitial pneumonia
cytogenic organizing pneumonia
pathological pattern for IPF and other associated conditions
usual interstitial pneumonia (UIP)
diagnosis of exclusion
idiopathic pulmonary fibrosis (IPF)/ UIP
NSIP
main cause IPF
smoking
genetic mutations associated with IPF
TERT and TERC- telomerase
increased MUC5B secretion
pathological markers for UIP/IPF
honeycombing- widened septa
temporal heterogeneity
dense collagenous fibrous areas mixed with normal lung
stiff lungs
IPF treatment
lung transplant
causes of UIP
collagen vascular disease drug toxicity chronic hypersensitivity pneumonitis asbestosis familial idiopathic pulmonary fibrosis
radiological findings for diffuse interstitial disease
small nodules irregular lines (ground glass shadows)
causes of NSIP
collagen vascular disease hypersensitivy pneumonitis drug induced pneumonitis infection immunodeficiency
NSIP descriptors
cellular or fibrosing pattern
lack of temporal heterogeneity
46-55
which is better prognosis cellular or fibrosing pattern of NSIP?
cellular
IPF descriptors
smoker
>50y
gradual deterioration with hypoxemia, cyanosis, clubbing
cytogenic organizing pneumonia
unknown cause
polypoid plugs of loose CT in alveolar ducts, alveoli, bronchioles
lack of temporal heterogeneity
no interstitial fibrosis
lack of temporal heterogenity
cytogenic organizing pneumonia
NSIP
temporal heterogenity
IPF/UIP
honeycomb lung
IPF/UIP
asbestosis
cryptogenic organizing pneumonia is similar to
**usually unknown viral/bacterial pneumonia inhaled toxins collagen vascular disease GVHD
diseases associated with pulmonary involvement in collagen vascular disease
systemic sclerosis
lupus
RA
prognosis better than IPF
pneumoconeosis
nonneoplastic responses to inhaled particulates from occupational exposures
pneumoconeosis diagnosis
b readings- radiography
pulmonary function tests
biopsy
autopsy
1 treatment for pneumoconeoses
prevention
anthracosis
carbon particles along lymphatics with no fibrosis
CWP
simple CWP
carbon accumulation in respiratory bronchioles with fibrosis
nodules to larger macules in upper lobes and upper zones of lower lobes along the respiratory bronchioles
little to no pulmonary dysfunction
progressive massive fibrosis
large black scars with significant decrease in lung function
takes years to develop
center may be necrotic
severe CWP and sillicosis
acute silicosis
accumulation of protein rich fluid in alveoli
accelerated silicosis
nodular fibrosis complications in years
preferred lob for silicosis
upper lobes
which type of asbestos is worse
amphibole is worse than chrysotile
chrysotile is more common in US
preferred lobe for asbestosis
lower
pathological features of asbestosis
honeycombing
pleural plaques
asbestos bodies- fiber coated in iron
