Flashcards in Interstitial Lung Disease Deck (19):
Only method that can distinguish the 4 categories of Diffuse Parenchymal Lung Disease.
-surgical is needed b/c a large sample required
-bronchoscopic not sufficient
Most common type of Idiopathic Interstitial Pneumonia
Idiopathic Pulmonary Fibrosis (IPF)
Usual Interstitial Pneumonia (UIP) pattern on Bx
Main culprit in starting the cascade of tissue damage in Interstitial Lung Disease.
Which 2 types of Idiopathic Interstitial Pneumonia can be reversed simply by quitting smoking?
Desquamative Interstitial Pneumonia
Respiratory Bronchiolitis IP
What other conditions can show a UIP pattern on biopsy?
Collagen Vascular Disease
Drug Induced lung disease
Occupational or Environmental disorders
What is the prognosis for a pt diagnosed with Idiopathic Pulmonary Fibrosis?
Death within 3-8 years
-cough becomes debilitating, cyanosis and cor pulmonale occur in later stages
Diagnostic test of choice for IPF.
High Resolution CT scan (HRCT)
How does IPF appear on CT?
Bilateral Peripheral opacities in the base of the lung
What is the only treatment proven to increase survival in patients with IPF?
How are Desquamative IP and Respiratory Bronchiolitis IP differentiated on CT?
DIP shows a more diffuse infiltrate in the tiny air spaces
RBIP shows a sharp well-defined infiltrate in the respiratory bronchioles
What is Sarcoidosis?
A syndrome involving abnormal collections of chronic inflammatory cells (granulomas) that can form as nodules in multiple organs, mainly in the lungs and CNS.
Best way to Dx sarcoidosis.
-it's often asymptomatic and found incidentally
What are the 5 stages of Sarcoidosis on Radiology?
Stage 0: Normal
Stage 1: Bilateral Hilar Lymphadenopathy
Stage 2: BHL and parenchymal infiltrates
Stage 3: Parenchymal Infiltrates without BHL
Stage 4: End Stage Fibrotic Lung Disease
What laboratory levels will be abnormal in patients with sarcoidosis?
Hypercalcemia w/ hypercaliuria
High ACE levels
How is sarcoidosis treated?
Since it is a granuloma inflammatory process, corticosteroids work very well to suppress the immune system.
Only serious cases need to be treated since many patients are asymptomatic
What is Hypersensitivity pneumonitis and what causes it?
Immune induced, non-IgE mediated, inflammatory lung disease. (originally case was called Farmer's Lung)
Caused by repeated exposure to an organic causative agent (dusts, allergens)
What is the Pathogenesis of Hypersensitivity Pneumonitis?
Mostly Type III hypersensitivy with Immune complex deposition in the parenchyma.
Some cases show Type IV T-cell mediated response leading to parenchymal fibrosis.
Best treatment for Hypersensitivity Pneumonitis.
Prevention and Avoidance of the offending agent.