Interstitial lung disease Flashcards

(29 cards)

1
Q

What is interstitial lung disease?

A

Any disease process affecting the lung interstitium i.e. the alveoli and terminal bronchi.

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2
Q

What kind of pattern does this produce on spirometry?

A

Restrictive. FVC will be reduced.

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3
Q

What kind of hypersensitivity reaction is sarcoidosis?

A

Type 4 hypersensitivity

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4
Q

What does type 4 hypersensitivity mean?

A

Delayed-type reactions i.e. T-cell mediated

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5
Q

What characterises sarcoidosis?

A

Multi-system involvement
Non-caseating granulomas
Unknown aetiology

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6
Q

What are some of the features of acute sarcoidosis?

A
Erythema nodosum
Uveitis
Bilateral hilar lymphadenopathy
Arthritis
Fever
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7
Q

What are some of the features of chronic sarcoidosis?

A
Lung infiltrates i.e. alveolitis
Skin infiltrations
Peripheral lymphadenopathy
Hypercalcaemia
Multi-system involvement e.g. renal, myocardial, neurological
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8
Q

What are some differential diagnoses of sarcoidosis?

A

TB
Lymphoma
Carcinoma
Fungal infection

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9
Q

How is the diagnosis of sarcoidosis made?

A
CXR
Bronchoscopy
Biopsy
CT 
Spirometry
Blood test - calcium levels and inflammatory markers
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10
Q

What type of hypersensitivity reaction is extrinsic allergic alveolitis?

A

Type 3 hypersensitivity

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11
Q

What does type 3 hypersensitivity mean?

A

Immune complex mediated hypersensitivity i.e. involvement of antibodies

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12
Q

What kind of diseases does extrinsic allergic alveolitis include?

A

Bird fanciers lung
Malt workers lung
Farmers lung

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13
Q

What are some of the symptoms of acute extrinsic allergic alveolitis?

A
Cough
Breathlessness
Myalgia
Pyrexia
Hypoxia
Crackles
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14
Q

When does the onset of symptoms of acute extrinsic allergic alveolitis tend to occur?

A

Several hours after exposure

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15
Q

What are some of the symptoms and signs of chronic extrinsic allergic alveolitis?

A

Progressive breathlessness and cough

Crackles

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16
Q

What abnormalities would you expect to see on CXR with suspected diagnosis of extrinsic allergic alveolitis?

A

Widespread pulmonary infiltrates/may have progressed to fibrosis, particularly in upper zones
Lung biopsy can be done if in doubt

17
Q

What is the treatment for EAA?

A

Removal of antigen
Oxygen in acute exacerbation
Steroids

18
Q

What is the clinical presentation of idiopathic pulmonary fibrosis?

A

Progressive breathlessness
Dry cough
Finger clubbing
Fine inspiratory crackles bilaterally

19
Q

What abnormalities would you expect to see on CXR in suspected diagnosis of idiopathic pulmonary fibrosis?

A

Bilateral infiltrates

20
Q

What kind of histological changes might you see in idiopathic pulmonary fibrosis?

A

Chronic inflammatory infiltrate i.e. neutrophils and fibrosis in alveolar walls and/or intra-alveolar macrophages

21
Q

What treatment is available for idiopathic pulmonary fibrosis?

A

Lung transplant indicated for younger patients

22
Q

Can idiopathic pulmonary fibrosis result in death?

A

Yes - death within roughly five years due to type 1 respiratory failure

23
Q

What are some of the features of coal workers pneumoconiosis?

A

Initially just a CXR abnormality
Progressive massive fibrosis
Restrictive lung pattern
Breathlessness

24
Q

What are (ex-)coal workers who smoke at particular risk of developing?

A

Chronic bronchitis

25
What is Caplan's syndrome?
Rheumatoid pneumoconiosis
26
What is silicosis?
An interstitial lung disease which develops after 15-20 years exposure to quartz
27
Which workers are particularly at risk of developing silicosis?
Coal miners Glass workers Boiler workers
28
What is the characteristic appearance of silicosis on CXR?
"Egg-shell" appearance
29
What are some complications of chronic silicosis?
Progressive breathlessness Restrictive lung pattern Pulmonary fibrosis