Lung 4 Flashcards
sarcoidosis
noncaseating granulomas involving multiple organ systems
diagnosis of exclusion
sarcoidosis (2 others)
difference between TB and sarcoidosis
sarcoidosis has no infection and rarely necrosis
TB is an infection and has necrosis
respiratory symptoms of TB
cough
dyspnea
pain
constitutional symptoms with TB
fever weight loss fatigue anorexia night sweats
lymphocyte associated
CD4/Th1
cytokines associated
IL2
INFgamma
antibody associated
IgG (elevated)
genetic risk factors
familial
HLA associations
3 main factors for etiology of sarcoidosis
immunologic factors
genetic factors
environmental factors
organs involved in sarcoidosis
spleen BM skin eye salivary glands muscle lungs
Lofgren syndrome
associated with sarcoidosis
fever
bilateral hylar lymphandenopathy, polyarthralgias
common in Scandanavians
Skin symptoms of sarcoidosis
erythema nudism
panniculitis
lupus pernio (most common)
rash of cheeks and nose
eye issues with sarcoidsosis
granulomatous uveitis or conjunctival lesions/scleral plaques
how are granulomas found in sarcoidosis
PET scans- take up more glucose
abnormal lab values associated with sarcoidosis
hypercalcemia
hypercalcinuria
high ACE
high alkaline phosphatase
CO diffusion test
decreased in sarcoidosis
restrictive or obstructive for sarcoidosis
restrictive
sarcoidosis treatmetn
NSAIDs
possible corticosteroids for extra pulmonary disease or persistent pulmonary disease
hypersensitivity pneumonitis
immune mediated interstitial lung disorder caused by exposure to inhaled organic dusts
hot tub lung
HP caused by mycobacterium avid complex from poorly maintained indoor hot tubs
HP restrictive or obstructive?
restrictive- reduced FVC
causative agent for hot tub lung
MAC
immunology of hypersensitivity pneumonitis
increase pro inflammatory cytokines
increased T lymphocytes
immune complexes
non caveating granulomas
pulmonary eosinophilia
lots of eosinophils in airways from unknown cause
types of pulmonary eosinophilia
acute eosinophilic pneumonia with respiratory failure simple pulmonary eosinophilia tropical secondary idiopathic chronic
smoking associated diffuse interstitial lung diseases
desquamative interstitial pneumonia (DIP)
respiratory bronchiolitis associated interstitial disease (RBILD)
DIP and RBILD characteristics
pigmented macrophages in air space
lack of fibrosis
40-50y M»F
DIP RBILD CXR
nodular with some interstitial infiltrate in lower lobes
drug induced lung disease
interstitial fibrosis
bronchiolitis obliterans
eosinophilic pneumonia
pulmonary alveolar proteinosis
filling of airspaces with gelatinous sputum
CXR PAP
bilateral, patchy asymmetric infiltrate
cause of PAP
hereditary- mutations in GM-CSF and/or GM-CSF receptors
secondary
diagnosis
pink proteinaceous fluid
no inflamamtion
PAS positive with cholesterol clefts
treatment for PAP
BAL
lung transplant in children
major cause of pulmonary embolism
DVT in leg
gene involved with primary hypertension
BMPR2
plexogenic pulmonary arteriopathy
smooth muscle hyperplasia
presentation of primary HTN
women 20-40
dyspnea, fagitue –> can progress to respiratory distress, cyanosis, RVH
goodpasture syndrome
auto antibodies against collage 4
leads to glomerulonephritis and kidney failure
idiopathic pulmonary hemosiderosis
too much iron in lung, rare, seen in kids
