Pulmonary III Flashcards
What are the 5 types of Interstitial Lung Dz (ILD)?
- Hypersensitivity pneumonitis
- Eosinophilic pulmonary disorders
- Idiopathic interstitial pneumonias
- Drug-induced ILD
- Environmental causes of ILD
In hypersensitivity pneumonitis, what type of reaction is this?
Allergic (rxn usu occurs 4-6hrs post exposure)
What are some clues that would help you dx hypersensitivity pneumonitis?
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
There are three types of hypersensitivity pneumonitis, what are they and what are their defining s/sx?
- Acute - onset in 4-6hrs, fever/chills, dry cough
- Subacute - gradual onset, weight loss, ill appearance
- Chronic - insidious onset, exercise intolerance, clubbing, inspiratory squawk in some cases
What is a work-up for hypersensitivity pneumonitis?
CBC, allergy testing, PFT
What are some common complications of hypersensitivity pneumonitis?
Permanent lung damage with pulmonary fibrosis
Spontaneous pneumothorax
Cor pulmonale or death
What kind of response is an eosinophilic pulmonary disorder?
Allergic response to infxn (drug rxns, parasites, fungi, toxins)
What are the s/sx of acute eosinophilic pneumonia?
<7days of fever, dry cough, dyspnea, myalgia, night sweats, pleuritic chest pain, crackles
In chronic eosinophilic pneumonia, what is a common misdiagnosis and how do you prevent it?
Community acquired pneumonia
CBC (see elevated EOS), inc. ESR, CXR
What are the 4 types of pneumoconiosis?
- Asbestosis
- Silicosis
- Anthracosis
- Berylliosis
What can asbestosis lead to?
Bronchogenic carcinoma and malignant pleural mesothelioma
What is the causative agent in silicosis?
Silica from mining, pottery, sand-blasting, brick-making, foundries, glassmakers
What is the progression of silicosis?
Sx appear 5-20yr after 1st exposure with >1cm nodules in upper lobes with eggshell calcification.
What is the causative agent of anthracosis?
Anthracite = coal
What is the causative agent in berylliosis?
Mineral beryllium dust (electronics)
What are the types of environmental ILD?
- Pneumoconiosis
- Occupational asthma
- Irritant gas inhalation injury
- Air pollution-related illness
An Inflammatory leukocytic disease in pulmonary and blood vessel walls with reactive damage to mural structures, leading to bleeding, ischemia, and necrosis.
Pulmonary vasculitides
What are the two types of pulmonary vasculitides?
- Wegener’s granulomatosis - autoimmune rxn
2. Churg-Strauss syndrome - allergic granulomatosis and angiitis
What are the three connective tissue disorders?
- Goodpasture’s syndrome - pulmonary hemorrhage with severe and progressive glomerulonpehritis
- Rheumatoid lung dz - assoc with RA
- Lupus (SLE) - autoimmune dz
What is the etiology of pulmonary amyloidosis?
Amyloid protein deposition in the lung
An inflammatory dz of unknown etiology that results in non-caseating granulomas in the lungs and other organs.
Sarcoidosis
What other organ systems can sarcoidosis effect? Give an example of each.
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
What would you include in your workup for someone you think may have sarcoidosis?
PFT, CBC, CMP, LFT
CXR, CT, Bronchoscopy
How do you Dx a case of sarcoidosis?
Biopsy of granuloma, CXR, CBC with anemia
