Week 8 - ILD Flashcards
What is interstitial lung disease?
-A group of diseases which affect the interstitium of the lung and diffuses into surrounding structures including the alveoli and bronchioles
What cells are involved in ILD?
-Epithelial, endothelial, mesenchymal, macrophages, recruited inflammatory cells
Why in ILD is there decreased pO2 but increased pCO2?
- Initially due to solely effects on ventilation as alveoli are full of inflammatory exudate
- Eventually because diffusion of gases is affected due to thickening of interstitium and also due to decreased perfusion due to destruction of capillaries
What is a characteristic sign of ILD on a CT?
-Honeycombing
How will the onset of symptoms be in ILD?
-Gradual decline
What are the two commonly presenting symptoms with ILD?
-Shortness of breath and cough
What respiratory symptoms are not present on presentation of ILD?
- Haemoptysis
- Wheeze
- Chest tightness
What respiratory signs might be present in ILD?
- Clubbing
- Cyanosis
- Tachycardia
- Dyspnoea
- Signs of RHF
What are the 5 categories which cause interstitial lung disease?
- Occupational
- Treatment related
- Connective tissue disease
- Immunological
- Idiopathic
Name some occupational ILD?
- Asbestosis
- Coal worker’s pneumoconiosis
Give some examples of treatments which predispose to ILD?
- Methotrexate (rheumatoid arthritis)
- Radiation
- Chemotherapy
Name 2 connective tissue diseases which cause ILD?
- Systemic Lupus Erythema
- Rheumatoid arthritis
Name an immunological cause of ILD
-Sarcoidosis
What type of pattern is shown in spirometry in ILD?
-Restrictive
What is the most common ILD?
-Idiopathic pulmonary fibrosis
At what age do patients with idiopathic pulmonary fibrosis usually present?
-60-80s
What is the median survival age for idiopathic pulmonary fibrosis?
-3 years
How is ILD usually diagnosed?
-CT
How does asbestos cause ILD?
- Inhaled fibres of asbestos penetrate the lung and activate an inflammatory response forming asbestos plaques.
- This inflammation results in diffuse pleural thickening which is chronic in nature
What malignancy risk is increased with asbestosis?
-Mesothelioma
What is sarcoidosis?
-Autoimmune condition of idiopathic nature characterised by non-caseating granuloma formation all over the body, especially in lumgs, lymphnode and liver
Give two differential diagnosis for sarcoidosis
- Lymphoma
- TB
What type of cough is present in ILD?
-dry
What is pleuritic chest pain?
-Sharp, knife like pain, worse with inspiration