Session 8 - Intertstial Lung Disease Flashcards
What is the interstitial space?
A potential space between the alveolar cells and the capillary basement membrane which is only apparent in disease states
Give some causes of interstitial lung disease
- Asbestosis
- Silicosis
- Radiation
- Rheumatoid arthritis
- sarcoidosis
What are some of the symptoms of Interstitial lung disease?
- Shortness of breath
- Low exercise tolerance
- Dry cough
What are some of the signs of interstitial lung disease?
- Tachypnoea, tachycardia, cyanosis and signs of right sided heart failure
- Smaller chest movements and coarse crackles
- clubbing
How does interstitial lung disease effect ventilation?
- Fibrotic tissue makes lungs less compliant
- restrictive ventilatory defect
- airway resistance is not increased
- FEV1 : FVC ratio be >70%
How does interstitial lung disease effect gas exchange?
- diffusion path will be lengthened
- impairs gas exchange
- oxygen transport particularly effected
What will be seen on a CXR of a patient with Fibrosing Alveolitis?
- Small lungs
- Micro-nodular shadowing
- ragged heart borders
What will be seen on a CXR of a patient with asbestosis?
- Plaques
- Fibrosis
- Mesothelioma
What is the importance of the surface tension on the pleural fluid?
- Ensures the two layers of the pleura stick together
- hence when chest wall expands the pleura stick together
- this then causes the lungs to expand allowing them to be filled
When may too much pleural fluid be produced?
- raised hydrostatic pressure (e.g. Heart failure)
- increased permeability of endothelium (inflammation, sepsis)
- Decreased oncotic pressure (liver failure)
What are the different types of pleural effusion and what does each contain?
Haemothorax - blood
Chylothorax - Chyle (lymp containing fats)
Empyema - pus
Simple effusion - serous fluid
What is the difference between transudate and exudate? Give figures also
Transudates have low protein content = <30g/L
Exudate have high protein content = >30g/L
When may exudates be formed?
- Neoplasms
- Infection
- Immune diseases (CT diseases. Rh. Arthritis)
- Ab diseases (Pancreatitis, ascites)
Give some causes of pleurisy
- Infection (TB, pneumonia, viral inf like flu)
- Autoimmune (Rh. Arthritis)
- Lung Cancer
- Pneumothorax
- Pulmonary embolism
Describe the signs and symptoms of pleurisy
- Sharp pain on inspiration
- pain worse when coughing, laughing or sneezing
- patients take small breaths and hold affected side of chest
- Pleural rub - creaking noise heard through stethoscope with resp movements
