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respiratory > parenchymal lung disease > Flashcards

parenchymal lung disease Flashcards

1
Q

another name for parenchymal lung disease

A

interstitial lung disease

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2
Q

what are they characterised by

A
  • inflammation

- fibrosis

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3
Q

where does it affect initially

A

interstitium of lung

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4
Q

what does it present with

A
  • exertional dyspnoea

- maybe cough

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5
Q

granulomatous diseases

A
  • sarcoidosis
  • hyperesensitivity pneumonitis
  • infections e.g. TB
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6
Q

what is most common cause of ILD

A

idiopathic pulmonary fibrosis

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7
Q

what is the cause of IPF

A

unknown

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8
Q

when is IPF onset

A

sixties

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9
Q

who is more likely to get IPF men or women

A

men

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10
Q

what is histological finding in IPF

A

interstitial pneumonia

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11
Q

what is seen in lung pathology of IPF

A
  • marked fibrosis

- honeycombing

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12
Q

what happens to elasticity of lung in IPF

A

there is a loss

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13
Q

where can TB affect

A

anywhere

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14
Q

symptoms of IPF

A
  • progressive dyspnoea
  • cough
  • mucus (sometimes)
  • finger clubbing
  • bi-basal end inspiratory crackles
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15
Q

spirometry results in IPF

A

restrictive

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16
Q

what is done to diagnose IPF

A

CT

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17
Q

what does CT show in IPF

A
  • basal distribution
  • subpleural reticulation
  • traction bronchiectasis
  • honeycombing
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18
Q

how does honeycombing show in CT

A

cystic airspaces with irregularly thickened walls

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19
Q

when is bronchoalveolar lavage done for IPF

A

in infective or malignant cause suspected

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20
Q

differential diagnosis for IPF

A
  • interstitial pulmonary oedema
  • infection
  • lymphangitis carcinomatosa
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21
Q

what is survival rate for IPIF

A

2-5 years

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22
Q

treatment of IPF

A
  • pirfenidone

- nintedanib

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23
Q

what is pirfenidone

A

an antifibrotic agent

SE: rash

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24
Q

what is nintedanib

A

inhibitor of tyrosine kinases

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25
Q

what causes hypersensitivity pneumonitis

A

allergic reaction affecting the small airways and alveoli

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26
Q

what are the causes of hypersensitivity pneumonitis

A
  • farmers
  • bird fanciers
  • maltworkers
  • humidifier
  • mushroom worker
  • cheese washer
  • winemaker
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27
Q

what is most common cause of hypersensitivity pneumonitis

A

farmer lung

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28
Q

histological findings of hypersensitivity pneumonitis

A
  • chronic inflammatory infiltrate
  • poorly defined interstitial granulomas
  • interstitial fibrosis and honeycomb
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29
Q

symptoms of hypersensitivity pneumonitis

A
  • malaise
  • dyspnoea
  • cough
  • weight loss
  • inspiratory squeaks
  • fine crackles
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30
Q

when do symptoms present for hypersensitivity pneumonitis

A

4-6 hours after exposure

31
Q

what does CT show in hypersensitivity pneumonitis

A

ground glass appearance

32
Q

what is spirometry in hypersensitivity pneumonitis

A

restrictive

33
Q

what can bronchoalveolar lavage good in hypersensitivity pneumonitis

A

to differentiate between sarcoidosis

34
Q

treatment of hypersensitivity pneumonitis

A
  • avoidance of exposure

- prednisolone

35
Q

does fibrosis resolve

A

no

36
Q

what causes humidifier fever

A
  • humidifiers

- air conditioning units

37
Q

what is langerhans cell histiocytosis characterised by

A

proliferaiton of langerhans cells

38
Q

what is langerhans cell histiocytosis associated with

A

smoking

39
Q

what does CT show in langerhans cell histiocytosis

A
  • interstitial thickening
  • nodules
  • cysts
  • honeycombing
40
Q

treatment for langerhans cell histiocytosis

A
  • smoking cessation
  • corticosteroids
  • chemotherapy agents
  • lung transplant
41
Q

what is Pulmonary lymphangioleiomyomatosis

A

rare disorder of premenopausal women

42
Q

wha does Pulmonary lymphangioleiomyomatosis cause

A

hamartomatous smooth muscle infiltration of lungs

43
Q

treatment of Pulmonary lymphangioleiomyomatosis

A
  • lung transplantation
44
Q

what is a granuloma

A

mass or nodule composed of chronically inflamed tissue formed by the response of the mononuclear phagocyte

45
Q

what is granuloma characterised by

A

presence of epithelioid multinucleate giant cells

46
Q

why does granuloma formation occur

A

to confine a pathogen and limit the extent of surrounding inflammation

47
Q

where are granulomas seen

A
  • TB
  • fungal infections
  • sarcoidosis
  • hypersensitivity pneumonitis
48
Q

what is sarcoidosis

A

multisystem granulomatous disorder

49
Q

who does sarcoidosis affect

A

young adults

50
Q

wha does sarcoidosis present with

A
  • bilateral hilar lymphadenopathy
  • pulmonary infiltration
  • skin or eye lesions
51
Q

what other infection can mimic sarcoidosis

A

beryllium posoning

52
Q

how is sarcoidosis detected

A

CXR

53
Q

who is most likely to contract sarcoidosis

A

Afro-Caribbean

54
Q

what is Mantoux test results in sarcoidosis

A

negative

55
Q

where can sarcoidosis affect

A

any organ

56
Q

symptoms of sarcoidosis

A
  • eye, skin or lymph nodes involved
  • fatigue
  • bilateral hilar lymphadenopathy
  • erythema nodosum
  • arthralgia
  • fever
  • wheeze
  • SOB
  • cough
  • hepatomegaly
57
Q

HRCT in sarcoidosis

A

non-caseating granulomas

58
Q

what is bilateral hilar lymphadenopathy associated with

A
  • dull ache in chest
  • malaise
  • mild fever
59
Q

what is most common cause of erythema nodosum

A

sarcoidosis

60
Q

what is initial test for sarcoidosis

A

chest x-ray

61
Q

what does transbronchial biopsy show in sarcoidosis

A
  • non-caseating granulomas
62
Q

first line treatment for sarcoidosis

A

prednisolone

4-6 weeks

63
Q

what is 2nd line treatment for sarcoidosis

A

immunosuppressant

e.g. methotrexate, azathioprine

(can be added to prednisolone)

64
Q

what is end stage treatment for sarcoidosis

A

lung transplantation

65
Q

who does Granulomatosis with polyangiitis affect

A

older adults

66
Q

what is c-ANCA result in Granulomatosis with polyangiitis

A

positive with elevated PR3 antibodies

67
Q

symptoms of Granulomatosis with polyangiitis

A
  • bloody nasal discharge
  • crusting and destruction
  • sinusitis
  • cough
  • dyspnoea
  • pleuritic chest pain
68
Q

how should diagnosis be confirmed in Granulomatosis with polyangiitis

A

biopsy

69
Q

another name for Anti-glomerular basement membrane disease

A

Goodpasture syndrome

70
Q

what is goodpasture syndrome characterised by

A
  • pulmonary haemorrhage
  • glomerulonephritis
  • presence of circulating antibodies
71
Q

treatment of Goodpasture syndrome

A

plasmapheresis

prevents further antibody production

72
Q

what is caplan syndrome due to

A

occupational dust inhalation

73
Q

who gets caplan syndrome

A

coal workers pneumoconiosis

74
Q

haven’t done pulmonary infiltration with eosinophilia

A

haven’t done pulmonary infiltration with eosinophilia

respiratory (20 decks)

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