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CPD I > Pulmonary III > Flashcards

Pulmonary III Flashcards

1
Q

What are the 5 types of Interstitial Lung Dz (ILD)?

A
  1. Hypersensitivity pneumonitis
  2. Eosinophilic pulmonary disorders
  3. Idiopathic interstitial pneumonias
  4. Drug-induced ILD
  5. Environmental causes of ILD
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2
Q

In hypersensitivity pneumonitis, what type of reaction is this?

A

Allergic (rxn usu occurs 4-6hrs post exposure)

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3
Q

What are some clues that would help you dx hypersensitivity pneumonitis?

A

Hx of recurrent pneumonia, respiratory sx after move to new building (work, school, home), hx of contact with birds, water damage, use of swimming locations

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4
Q

There are three types of hypersensitivity pneumonitis, what are they and what are their defining s/sx?

A
  1. Acute - onset in 4-6hrs, fever/chills, dry cough
  2. Subacute - gradual onset, weight loss, ill appearance
  3. Chronic - insidious onset, exercise intolerance, clubbing, inspiratory squawk in some cases
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5
Q

What is a work-up for hypersensitivity pneumonitis?

A

CBC, allergy testing, PFT

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6
Q

What are some common complications of hypersensitivity pneumonitis?

A

Permanent lung damage with pulmonary fibrosis
Spontaneous pneumothorax
Cor pulmonale or death

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7
Q

What kind of response is an eosinophilic pulmonary disorder?

A

Allergic response to infxn (drug rxns, parasites, fungi, toxins)

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8
Q

What are the s/sx of acute eosinophilic pneumonia?

A

<7days of fever, dry cough, dyspnea, myalgia, night sweats, pleuritic chest pain, crackles

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9
Q

In chronic eosinophilic pneumonia, what is a common misdiagnosis and how do you prevent it?

A

Community acquired pneumonia

CBC (see elevated EOS), inc. ESR, CXR

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10
Q

What are the 4 types of pneumoconiosis?

A
  1. Asbestosis
  2. Silicosis
  3. Anthracosis
  4. Berylliosis
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11
Q

What can asbestosis lead to?

A

Bronchogenic carcinoma and malignant pleural mesothelioma

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12
Q

What is the causative agent in silicosis?

A

Silica from mining, pottery, sand-blasting, brick-making, foundries, glassmakers

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13
Q

What is the progression of silicosis?

A

Sx appear 5-20yr after 1st exposure with >1cm nodules in upper lobes with eggshell calcification.

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14
Q

What is the causative agent of anthracosis?

A

Anthracite = coal

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15
Q

What is the causative agent in berylliosis?

A

Mineral beryllium dust (electronics)

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16
Q

What are the types of environmental ILD?

A
  1. Pneumoconiosis
  2. Occupational asthma
  3. Irritant gas inhalation injury
  4. Air pollution-related illness
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17
Q

An Inflammatory leukocytic disease in pulmonary and blood vessel walls with reactive damage to mural structures, leading to bleeding, ischemia, and necrosis.

A

Pulmonary vasculitides

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18
Q

What are the two types of pulmonary vasculitides?

A
  1. Wegener’s granulomatosis - autoimmune rxn

2. Churg-Strauss syndrome - allergic granulomatosis and angiitis

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19
Q

What are the three connective tissue disorders?

A
  1. Goodpasture’s syndrome - pulmonary hemorrhage with severe and progressive glomerulonpehritis
  2. Rheumatoid lung dz - assoc with RA
  3. Lupus (SLE) - autoimmune dz
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20
Q

What is the etiology of pulmonary amyloidosis?

A

Amyloid protein deposition in the lung

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21
Q

An inflammatory dz of unknown etiology that results in non-caseating granulomas in the lungs and other organs.

A

Sarcoidosis

22
Q

What other organ systems can sarcoidosis effect? Give an example of each.

A

Skin - erythema nodosum, plaques, nodules, granulomas on old scars
Neuro - Bell’s palsy, basal granulomatous meningitis, peripheral neuropathies
Ocular - uveitis, conjunctival infiltration
MS - myositis, polyarthritis, spondyloarthropathy
URI - dry cough, crackles, tonsilitis, epiglotitis
Cardiac - cor pulmonale, tachychardia, arryhythmia, CHF
Abdominal - Splenomegaly, hepatomegaly, nephrolithiasis

23
Q

What would you include in your workup for someone you think may have sarcoidosis?

A

PFT, CBC, CMP, LFT

CXR, CT, Bronchoscopy

24
Q

How do you Dx a case of sarcoidosis?

A

Biopsy of granuloma, CXR, CBC with anemia

25
Q

What is the course of sarcoidosis?

A

2/3 of cases appears briefly and disappears
20-30% permanent lung damage
10-15% have chronic dz

26
Q

What are some DDx in sarcoidosis?

A

TB, Aspergillosis, Histoplasmosis, RA, Lymphomas, hypersensitivity pneumonitis

27
Q

What is the second most common cancer type in men and women?

A

Lung CA

28
Q

Where in the lung does SCLC arise?

A

In the airways

29
Q

What are the three types of NSCLC?

A

Adenocarcinoma
SCC
Large cell carcinoma

30
Q

Where does adenocarcinoma arise in the lung tissue?

A

In the periphery

31
Q

Where does SCC arise in the lungs?

A

In the larger airways

32
Q

Where does large cell carcinoma arise in the lungs?

A

The periphery

33
Q

What are some risk factors associated with lung CA?

A

Smoking, second-hand smoke, radon, asbestos, genetics

34
Q

What are the s/sx of a centrally arising tumor in the lung?

A

Cough, dyspnea, atelectasis, wheezing, hemopytsis

35
Q

What are the s/sx of a peripherally arising tumor in the lung?

A

Cough, dyspnea, pleural effusion

36
Q

Where does lung cancer tend to metastasize?

A

Liver, Brain, Bone

37
Q

What are some key PE findings in lung CA?

A

Decreased breath sounds

dullness to percussion

38
Q

How do you Dx lung CA?

A

CXR, biopsy

39
Q

What are the s/sx of ARDS?

A

Usu develops within 72hrs of initial injury/illness

dyspnea, tachypnea, pulmonary hypertension

40
Q

What is the mortality rate of ARDS?

A

Ranges from 35-50%; death usu results from underlying dz

41
Q

A collapsing or closure of alveoli leading to diminished lung volume affecting all or part of the lung.

A

Atelectasis

42
Q

What are the two types of atelectasis?

A

Obstructive and Non-obstructive

43
Q

What is obstructive atelectasis?

A

Airway blockage where air trapped distal to the blockage is resorbed and the region becomes completely airless and collapses

44
Q

What are non-obstructive atelectasis causes?

A

Relaxation atelectasis - loss of contact between parietal and visceral pleura
Compression atelectasis - space occupying lesion pressing on the lung
Adhesive atelectasis - surfactant dysfunction
Cicatriceal atelectasis, replacement atelectasis, and rounded atelectasis

45
Q

What are the s/sx of atelectasis?

A

Can come on rapidly or gradually. Chronic form: middle lobe syndrome is asymptomatic at first, then progresses in severity

46
Q

What is dx of atelectasis?

A

CXR, CT

47
Q

What is the most common cause of a pulmonary embolism?

A

Blood clot from leg or pelvic vein (DVT)

48
Q

What are the s/sx of a pulmonary embolism?

A

Sudden onset of SOB, dyspnea, pleuritic pain, cough, hemoptysis

49
Q

What are some key PE findings in a pulmonary embolism case?

A

Abnormal splitting of S2
S4 gallop may be present
JVD on the neck
If DVT caused - inflamed vein in lower calf

50
Q

How do you dx a pulmonary embolism?

A

Using the modified Well’s criteria and a d-dimer assay

51
Q

What are some DDx of a PE?

A

Acute MI, tension pneumothorax, pericardial tamponade, pleurisy, bacterial pneumonia

CPD I (7 decks)

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