Other LR Diseases

Question 1

What do I need to know about Interstitial lung disease and pulmonary
fibrosis?

Answer 1

Not a sigle condition but an array of things. Three main things - occupational exposure to say silica dust, medications that can harm the lungs, or autoimmune disease such as rheumatoid arthritis.

Triggers fibroblasts to develop and destrcution of cells/ scarring of the lungs.

Signs and symptoms:
* Dyspnoea
* Dry cough

Question 2

What do I need to know about Asbestosis?

Answer 2

This is a specific presentation of interstitial lung disease arising from persistent exposure to asbestos.

Initial inflammation caused by inhalation of fibres activates alveolar macrophages – fibroblasts are among the cells triggered by the macrophages - fibrosis picture happens

Signs and symptoms:
* Dyspnoea
* Dry, persistent cough - not productive
* Inspiratory crackles
* Finger clubbing - quite a characteristic sign
* Pain or tightness in the chest

Can lead to a cancer

Question 3

What do I need to know about Obstructive Sleep Apnoea?

Answer 3

Contributory factors to the excessive relaxation of throat muscle causing obstructive sleep apnoea include being overweight, older age, diabetes, smoking, hypertension, chronic nasal congestion and asthma. **More a condition of older age. **

Signs and symptoms:
* Loud snoring and waking abruptly choking/gasping
* Headache, sore throat and open mouth breathing/dry mouth on waking
* Poor concentration and fatigue
* Mood alterations e.g. depression
* Hypertension

Question 4

What do I need to know about Bronchiolitis?

Answer 4

A more common diease of children, casued usually by viral pathogens. Essnetially an inury to bronchioles. Most commonly caused by RSV (respiratory syncytial virus), also flu,
coronavirus and rhinovirus

Signs and symptoms
* Nasal congestion
* Runny nose
* Cough
* Mild fever
* Difficulty breathing - child may be distressed
* Expiratory wheeze

Pathophysiology.
Injury to the bronchioles by infection leads to an inflammatory response and in some instances an IgE mediated allergic response
This leads to
* Increased mucus secretion
* Obstruction and constriction of bronchi
* Death of alveolar cells
* Deeper penetration by virus
* Residual mucous by-products in the small airways

Question 5

What do I need to know about TB?

Answer 5

Caused by airborne spread of Mycobacterium tuberculosis, immunocompromised individuals
are at greater risk of more generalized TB. Currently on the rise.

Pathophysiology - Inhaled infected droplets
are deposited in the terminal airspaces of the lungs.

TB is a vigorous antigen, which may elicit a fully resolving immune response - or a latent form of infection. I may remain pulmonary or spread out into other parts of the body

Signs and symptoms

• Coughing up blood
• Damp picture in the lungs
• Night sweats
• Weight loss
• Weakness
• Dry cough