Hypersensitivity Pneumonitis (Extrinsic Allergic Alveolitis)

Question 1

What is another term for hypersensitivity pneumonitis

Answer 1

Extrinsic allergic alveolitis

Question 2

What is hypersensitivity pneumonitis

Answer 2

1. Non-atopic, nonasthmatic inflammatory pulmonary disease
   *immune response to inhaled (organic) antigens
   *manifested via vet work/animal handling, lumbar milling/construction, textile workers

Question 3

What is use to confirm the diagnosis

Answer 3

1. Skin tests and serum precipitating antibodies
   *many time provoking antigen is never identified

Question 4

What are the different types of hypersensitivity pneumonitis

Answer 4

1. Farmers lung / mushroom pickers lung
2. Bagassosis
3. Maple bark-stripper diseases
4. Bird fancier lung
5. Vaping (EVALI)
6. Detergent workers lung
7. Popcorn lung

Question 5

What is Farmers lung / mushroom pickers lung

Answer 5

Exposed to micropolyspora faeni
*moldy hay / moldy compost

Question 6

What is Bagassosis

Answer 6

Exposure to thermoactinomycyes sacchari
*moldy sugar cane

Question 7

What is Maple bark-stripper diseases

Answer 7

Exposed to fungus cryptostroma corticale
*moldy marble bark

Question 8

What is Bird fancier lung

Answer 8

Affects bird keepers with long term exposure to proteins from bird feather, blood and excrement

Question 9

What is Detergent workers lung

Answer 9

Bacillus subtillis enzyme, enzyme additives

Question 10

What is e-cigarette or vaping product associated lung injury

Answer 10

1. First seen in 2019
   *MC male, under 35
2. Required hospitalization, ICU care intubation
3. Usage within three months of admission
4. THC or nicotine or both

Question 11

What are the signs and symptoms of EVALI

Answer 11

1. Acute or subacute
   *constitutional symptoms
   *respiratory symptoms
   *GI symptoms
2. Tachycardia
3. Tachypnea

Question 12

What is the treatment of EVALI

Answer 12

Corticosteroids

Question 13

What are the S/sx of HP (Acute illness)

Answer 13

1. Sudden onset 4-8 hours post-exposure
2. Malaise
3. Chills
4. Fever
5. Cough, dyspnea
6. Tachycardia
7. Tachypnea
8. Crackles
9. Cyanosis

Question 14

What are some diagnostic testing for HP (acute illness)

Answer 14

1. PFT (restrictive )
2. Chest radiograph
   *small nodular densities
3. CBC
   *increase WBC, left shit
4. Antibody panels for Pneumonitis
   *not diagnostic

Question 15

What is on the PE for HP (Subacute (15%) or chronic illness)

Answer 15

1. Insidious onset of chronic cough
2. Slowly, progressive dyspnea
3. Anorexia
4. Weight loss

Question 16

What are some diagnostic test to complete for HP (subacute or chronic illness)

Answer 16

1. Chest radiograph
   *evidence of fibrosis possible
2. Lung biopsy may be needed to diagnosis chronic HP

Question 17

What is the tx for HP

Answer 17

Acute
*identify and avoid cause ASAP
*oral steroid taper
*change in occupation and or hobby