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
what are the symptoms / presentations of wegener’s granulomatosis?
sinus symptoms
cough
hemoptosis
constitutional symptoms
which antibody is specific to wegener’s syndrome?
cANCA
what is the diagnosis for goodpasture’s syndrome?
presence of anti-glomerular base membrane antibodies
what is seen on bronchoscopy for goodpasture’s syndrome?
persistent bloody fluid that does not clear on serial samples
how can diffuse alveolar hemorrhage present?
as the initial manifestation of a pulmonary vasculitis
what is the triad of churg-strauss syndrome?
asthma
hypereosinophilia
necrotizing vasculitis
what are the two phases of churg-strauss syndrome?
prodrome
eosinophilic
what is are the organ involvements in churg-strauss syndrome?
reversible airflow limitation
CV complications
GI - can be severe
what is seen on lab findings for churg-strauss syndrome?
eosinophilia (diagnostic)
elevated IgE
positive pANCA
