Respiratory - Interstitial Lung Disease Flashcards
What are the main conditions of interstitial lung disease?
Idiopathic pulmonary fibrosis
Secondary pulmonary fibrosis
Hypersensitivity pneumonitis
Asbestosis
How does interstitial lung disease present?
Shortness of breath on exertion
Dry cough
Fatigue
What are the typical findings on examination in patients with idiopathic pulmonary fibrosis?
Bibasal fine end-inspiratory crackles
Finger clubbing
How is interstitial lung disease diagnosed?
Clinical features
High-resolution CT of thorax
Spirometry
What does High-resolution CT thorax show in interstitial lung disease?
Ground glass appearance
What does spirometry show in interstitial lung disease?
FEV1 and FVC equally reduced
FEV1:FVC greater than 70%
What is the general management of interstitial lung disease?
Treat underlying cause
Smoking cessation
Physiotherapy and pulmonary rehabilitation
Pneumococcal and flu vaccine
What is idiopathic pulmonary fibrosis?
Insidious onset of shortness of breath and dry cough over 3 months
Who is affected by idiopathic pulmonary fibrosis?
Over 50s
What is the prognosis of idiopathic pulmonary fibrosis?
2-5 years after diagnosis
What is used to treat idiopathic pulmonary fibrosis?
Pirfenidone- reduces fibrosis and inflammation
Nintedanib- reduces fibrosis and inflammation by inhibiting tyrosine kinase
What drugs can cause pulmonary fibrosis?
Amiodarone
Cyclophosphamide
Methotrexate
Nitrofurantoin
What conditions can cause secondary pulmonary fibrosis?
Alpha-1 antitrypsin deficiency
RA
SLE
Diffuse systemic sclerosis
Sarcoidosis
What is hypersensitivity pneumonitis?
Extrinsic allergic alveolitis
Type III and IV hypersensitivity reaction to allergens causing inflammation and damage to lung tissue
How is hypersensitivity pneumonitis diagnosed?
Bronchoalveolar lavage
Airways washed with saline to gather cells after fluid collected and analysed
Raised lymphocytes are a positive finding
