Non-infectious inflammatory diseases of the lung Flashcards
sarcoidosis
multisystem granulomatous inflammatory disease of unknown etiology
what are the risk factors for sarcoidosis (ethnicities, exposures)?
african americans
danes
swedes
exposure to insecticides, ag employment, microbial aerosols
what are the general manifestations / clinical presentation of sarcoidosis?
involvement of lymphatic and pulmonary system
dry cough, SOB
like TB without the infectious part
what is seen on PE with sarcoidosis?
adenopathy skin lesions (lupus pernio, erythema nodosum)
what is seen on labs in sarcoidosis?
calcium levels
liver enzymes
creatinine
what ancillary tests should be performed for sarcoidosis?
ECG (for heart block)
opthalmologic
TB
what is seen on PFTs in sarcoidosis?
restrictive
decreased TLC
decreased VC
decreased RV
decreased DLCO
usually interstitial - limits expansion
what is the diagnostic procedure for sarcoidosis? what does it check for?
bronchoscopy to check for
BAL - lymphocyte, granulocyte count
CD4/CD8
when are systemic corticosteroids indicated for sarcoidosis?
cardiac involvement ocular disease neuro disease hypercalcemia lupus pernio symptomatic stage II stage III
what are the CT diseases that affect the lung?
RA scleroderma SLE sjogren dermatomyositic and polymyositis
what are the demographics and clinical features of RA that affects the lung?
male > female 50-60 yo
ILD 50%
what is the presentation for rheumatoid lung disease?
non productive cough
dyspnea on exertion
may precede joint disease by years
clubbing
what are the auscultatory findings of rheumatoid lung disease?
inspiratory fine crackles
pleural rub
what are the radiographic findings of rheumatoid lung disease?
nodules that can cavitate
what are the medications for rheumatoid lung disease?
methotrexate
etanercept
infliximab
what lab result is indicative of rheumatoid lung disease? why?
low glucose
bacteria are consuming the glucose
what are the two types of diffuse scleroderma lung disease?
interstitial lung disease
limited (CREST)
what is indicative of interstitial lung disease form of scleroderma on auscultation? what type of lung physiology is represented?
inspiratory crackles
restrictive lung physiology
what is seen in the limited (CREST) form of scleroderma?
pulmonary HTN
decreased DLCO
what is the most common presentation of SLE pulmonary involvement? what are other findings?
serositis
alveolar hemorrhage
diaphragmatic dysfunction
increased risk for DVT/PE** (hypercoagulable state)
what constitutes sjogren syndrome lung involvement?
airway compromise
bronchiestasis and bronchiolitis
what is a common manifestation of polymyositis / dermatomyositis pulmonary involvement?
aspiration pneumonia secondary to pharyngeal muscle weakness
what are the PFT findings for polymyositis / dermatomyositis?
restrictive
wegener’s granulomatosis
what structures are involved?
necrotizing granulomatous vasculitis of small and medium vessels
upper and lower respiratory tract and kidneys
