Overview of Disease Flashcards
Asthma
eosinophillic, chronic inflammation of the large and small airways which is reversible
COPD
result of smoking - obstructive disease neutrophillic
Atopy
allergy
Airway Remodelling
as a result of chronic inflammation in the airway
Eosinophils
a white blood cell containing granules that are readily stained by eosin.
Neutrophils
most abundant type of granulocytes
Macrophages
a large phagocytic cell
Diurnal variability
variations between morning and night
Bronchodilator reversibility
The reversibility of the an airway disease by a bronchodilator
Chronic Bronchitis
neutrophillic inflammation
Emphysema
a form of COPD
Cor Pulmonale
condition that most commonly arises out of complications from high blood pressure (pulmonary hypertension). It’s also known as right-sided heart failure
ACOS
Asthma and COPD overlap syndrome - more responsive to to steroids
DPLD
Diffuse Parenchymal Lung Disease
What is the DPLD?
A restrictive thoracic disease - a disease of alveolar structures
Causes issues in gas exchange
There is fluid in the alveolar air spaces
CO2 not affected as ventilation is normal
What is the primary abnormality in DPLD?
hypoxia –> impaired gas exhange
What are the causes of DPLD?
Cardiac Pulmonary Oedema
Non-cardiac - i.e. sepsis or trauma causing leaking pulmonary capillaries
Causes of DPLD (3)
Infective Disease
Infarction
Other disease such as Autoimmune Rheumatoid, BOOP
Granulomatous Alveolitis
Collection of inflammatory cells
Extrinsic Allergic Alveolitis
Sarcoidosis
Extrinsic Allergic Alveolitis
Hypersensitivity Penumonitis Type 3 reaction
Farmers Lung - mouldy hay, granulomatous
Avian - bird allergens
Causes of drug induced alveolitis (4)
Amiodarone
Bleomycin
Methotrexate
Gold
Toxic Gas Fumes which cause alveolitis
Chlorine
Causes of fibrosing alveolitis
Rheumatoid
Cryptogenic
Auto-immune causes of Alveolitis
Systemic Lupus Eryhtmitis
Wegners
Churg-Strauss
Bechet’s
Another word for dust-disease
pneumoconiosis
Fibrogenic dust-disease (alveolitis)
asbestosis
silicosis
Non-fibrogenic dust disease (alveolitis)
Siderosis (Iron)
Stanosis (Tin)
Baritosis (Barium)
Eosinophillic causes of DPLD
Drugs - nitrofurantoin
Fungal - aspergillis
Parasites - toxocara, ascaris, filaria
Autoimmune - churg strauss, polyarteritis
Clinical Presentation of DPLD (6)
- Breathless on exertion
- Cough but no wheeze
- Finger Clubbing
- Inspiratory Lung Crackles
- Central cyanosis
- Pulmonary fibrosis occurs as end stage response to chronic inflammation
DPLD Diagnosis from:
History
Lung Volumes
Gas Diffusion
Arterial Oxygen
History - pets, occupation, drugs, arthritis
Lung Volumes - FEV1 and FVC decreased - normal ratio
Peak Flow Normal
Reduced Gas Diffusion TLCO
Decreased PaO2 and SaO2 at rest or exercise
1st Line Treatment of DPLD
Systemic corticosteroids
inhaled steroids are not effective
2nd Line treatment of DPLD
oral Azahioprine
Anti-fibrotic agents - Pirfenidone, Nintedanib
Anti-oxidant agents - Acetylcysteine
What is the last resort treatment for end stage DPLD?
Lung transplant
This is _______ ________ caused by sarcoidosis

Erythema Nodosum
What is shown here?

Bilateral hilar lymphadenopathy
Sarcoidosis