Restrictive Disorder Flashcards
What is interstitial lung dz (Diffuse Parenchyma lung dz)?
-inflammation of the parenchyma that has IRREVERSIBLE fibrosis
What is parenchyma?
lung tissues that includes the alveolar
What is a common finding of interstitial lung dz?
LATE INSPIRATORY CRACKLES
What pneumonia is a the most common in interstitial?
idiopathic interstitial pneumonia
What population is affected by IIP?
- 65 yo
- there are CXRs (basline) that show fibrosis over years
What PE for IIP?
inspiratory crackles
What labs of IIP?
- Hi Resolution CT
- patchy fibrosis WITH HONEY COMBING
- broncioalveolar lavage* for suspicions of pathogen
- transbronchial bx*
- surgical lung bx (dangerous)
What is broncialveolar lavage?
bronchoscope that is passed through the mouth or nose and sprays the lungs and collected to test for a pathogen
What is transbronchial bx?
safer than surgical lung bx and used to differentiate focal and diffuse/cystic and cavity lung dz
Tx IIP?
corticosteroids
Tx UIP?
lung transplant but only 50% of 5 yr survival rate
What is UIP?
Usual Intersitial Pneumonia under IIP
What is IIP?
- Idiopathic Interstitial Pneumonia
- under interstitial lung dz which is under fibrotic/restrictive disorder
What is sarcoidosis
- underlying systemic dz
- has granulomatous (collection of macrophages) d/t the inflammation in the lungs
Who does sarcoidosis affect?
- African Americans
- Females
- 30-40yo
PE of sarcoidosis?
- NO crackles
- it is a systemic dz cxing disoder: large parotid glands, hepatosplenomegaly, lymphadenopathy, fever
- INSIDEOUS ONSET
- CLASSIC: erythema around the ankles that are itchy and painful, peripheral neuropathy, arthritis, eye probs
Labs for sarcoidosis?
- bilateral hilar adenopathy (enlarged lymph nodes in the hilar part of lung b/c its a systemic dz!)
- CBC: leukopenia (only if pt doesn’t have splenomegaly which is rare); incr ESR (d/t inflammation); hypercalcemia/calciuria (d/t renal dz and increase PTH from the inflammatino of the granulomatous)
- lung bx: non necrosis granulomas
Tx for sarcoidosis?
oral corticosteroids (prednisone for months~yrs)
Prognosis for sarcoidosis?
best if NO parenchymal involvement (not affecting the lungs and JUST the body)
What is penumoconiosis?
having inorganic dusts in the lungs
What are the types of penumonocniosis?
- coal worker
- silicosis
- asbestosis
What is coal worker?
- the macrophages in the alveolar tries to engulf the coal particles cxing COAL MALCULES
- usually an asymptomatic finding
Labs for coal worker?
Hi Res CT:
-diffuse small opacities in upper lung
What is siliocosis?
- breathing in silica dust (construction workers)
- asymptomatic finding
Labs for siliocosis?
Hi Res CT:
-silicotic nodules w/ eggshell calcifications
What is absetosis?
hx of asbestosis fibers (shipyard construction)
PE for absetosis?
- PROGRESSIVE dyspnea
- inspiratory crackles
- clubbing
- cyanosis
Labs for absetosis?
Hi Res CT:
- linear streaking at the bases
- honeycombing
What are the restrictive lung dz?
- sarcoidosis
- interstitial lung dz (IIP –> UIP)
- pneumoconiosis
