Lung disease Flashcards
- What are the common themes of interstitial lung diseases?
They all affect the lung parenchyma, pulmonary injury leading to inflammation and fibrosis
- Define idiopathic pulmonary fibrosis (IPF).
Fibrotic lung disease, typically seen in men > 55 years old, unknown cause, may be associated with collagen vascular disease, acid reflux may contribute to disease progression
- What are the symptoms of IPF?
Dry cough and progressive dyspnea, restrictive defect (low Total Lung Capacity), hypoxemia, dx is confirmed by CT, will progress to respiratory failure and death > 50% in 5 years
- Radiology showing “honey-combing” in the periphery of the lung would be indicative of what disease?
IPF
- What are two pathologic processes of IPF?
Usual Interstitial Pneumonia (UIP) and Desquamative Interstitial Pneumonia (DIP)
- What characterizes each of the above processes? Which one is easier to treat?
UIP - extensive fibrosis, and distorted architecture; DIP – alveolar inflammation, macrophages in alveoli, and minimal fibrosis. DIP is easier to treat
- Why is exercise induced hypoxemia a common symptom of IPF?
Thickened, fibrotic tissue between the alveoli and the blood vessels results in inability of oxygen to perfuse across the capillary membrane and be delivered to the tissues
- What are the treatments for IPF?
Corticosteroids, immune suppressive therapy, Nintedanib and Pirfenidone, vaccination for influenza and pneumonia, pulmonary rehab, oxygen, palliative care, and lung transplant
- What is the average survival after lung transplant?
5 years
- What are the main complications after lung transplant?
Infection and rejection
- Define Sarcoidosis.
Chronic granulomatous lung disease of unknown etiology. Can affect many organs, but the lung is most frequently involved
- What are the symptoms of sarcoidosis?
Often asymptomatic, dyspnea, and cough, often spontaneous remission occurs and progression of disease is uncommon
- What is often found on the chest x-ray of people with sarcoidosis?
Symmetrical, and bilateral “Idaho potato” hilar lymph nodes
- What CXR finding characterizes sarcoidosis as Stage II?
Parenchymal tissue involvement
- What CXR finding characterizes sarcoidosis as Stage III?
Lose the enlarged hilar lymph nodes, parenchymal tissue involvement remains
- What is the pathogenesis of sarcoidosis?
Inflammation and activation of T-lymphocytes, formation of granulomas, minimal fibrosis
- What term is defined as an immune reaction to organic dust; such as, moldy hay, or bird droppings that results in pulmonary inflammation?
Hypersensitivity pneumonitis
- What diseases are hypersensitivity reactions often misdiagnosed as?
Flu or pneumonia
- How is misdiagnosis prevented?
Do a thorough patient history.
- What are the clinical manifestations of acute hypersensitivity pneumonitis?
Fever, cough, dyspnea, low PaO2 and decreases total lung capacity
- How does chronic hypersensitivity reaction develop?
Continued exposure to the inflammatory agent
- How is hypersensitivity pneumonitis treated?
Avoid exposure, supportive therapy, corticosteroids
- What disease is defined as an interstitial lung disease caused by inhalation of inorganic dust, typically occupational: silica, asbestos, or beryllium?
Pneumoconiosis
- What causes silicosis? What disease are people with silicosis at higher risk for?
Inhalation of silica dust, Increased risk for TB
- How long does asbestosis take to develop?
20-30 years
- What denotes asbestosis on CXR?
Calcified plaques
- What denotes asbestosis on lung biopsy?
Asbestos bodies
- What are the asbestos related lung diseases?
Lung cancer, pleural plaques, pleural effusion, mesothelioma (cancer of the pleural lining)
- What is the leading causes of cancer death in men and women?
Lung cancer
- What are the common symptoms of lung cancer?
cough, sputum, hemoptysis, weight loss, may be asymptomatic
- What are the two main types of lung cancers?
Small cell and non-small cells
- What are the three different types of non-small cell lung cancers?
Squamous, adenocarcinoma, and large cell
- Which type of lung cancer spreads the fastest?
Small cell
- Define pneumothorax.
Accumulation of air in the pleural space that can be spontaneous, or resulting from trauma or lung disease
- What are the symptoms of pneumothorax?
Sudden chest pain, shortness of breath, decrease breath sounds on the side of the pneumothorax
- How is a large, symptomatic pneumothorax treated?
Drainage or chest tube
- What is the difference between a pneumothorax and a pleural effusion?
Pneumothorax is air, pleural effusion is fluid; blood, serous fluid, or infected drainage
- What is the term for a pleural effusion composed of pus accumulation?
Empyema
- What are the symptoms of a pleural effusion?
Shortness of breath, fever, chest pain
- How is a large pleural effusion treated?
Drain it and treat the underlying cause
