First Aid, Chapter 7 Hypersensitivity Disorders, Interstitial Lung Disease Flashcards
What is the injury pattern in interstitial pneumonitis characterized by? What cytokines are involved? Via what cell? What is seen on early vs. late radiography?
The acute injury pattern of interstitial pneumonitis is characterized by fibroblastic foci. IL-1, -6, -8, and TNF are important cytokines involved via macrophages. “Ground-glass” appearance on early radiography versus “honeycombing” in the late phases.
What is the most common of the interstitial pneumonias?
Usual interstitial pneumonitis or idiopathic pulmonary fibrosis?
What are the symptoms of UIP?
- Dyspnea and/or nonproductive cough
- Diffuse interstitial infiltrates on chest radiographs
- Honeycombing on HRCT
- Restrictive pattern with low DLCO on spirometry
What gender has a worse prognosis in UIP?
Males
What is the treatment of UIP?
Steroids, lung transplantation.
What is Desquamative Interstitial Pneumonitis (DIP)?
DIP is an uncommon ILD. Ninety percent of these patients have a smoking history and present with “smoker’s bronchiolitis.” DIP has a better prognosis than UIP.
What is acute interstitial pneumonitis? What are the symptoms?
AIP is another uncommon ILD. It is also called Hamman-Rich syndrome and has a pathologic pattern of diffuse alveolar damage.
Characterized by:
-High fever
-Severe dyspnea over 1 day -Flu-like symptoms
-Rapid respiratory decompensation
What is nonspecific interstitial pneumonia (NSIP) or fibrosis? What is in the differential? What is the prognosis?
NSIP is yet another uncommon ILD, which is based on a diagnosis of exclusion. One must rule out collagen vascular disorders, organic dust inhalation, drug reactions, etc. Overall, NSIP has a good prognosis.
What are typical laboratory findings in HP?
Increased CD8 in BAL fluid with decreased CD4:CD8
Usual interstitial pneumonia is the typical pathologic pattern in patients with which clinical condition?
Idiopathic pulmonary fibrosis
