Interstitial lung disease Flashcards Preview

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Flashcards in Interstitial lung disease Deck (29):
1

What is interstitial lung disease?

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

2

What kind of pattern does this produce on spirometry?

Restrictive. FVC will be reduced.

3

What kind of hypersensitivity reaction is sarcoidosis?

Type 4 hypersensitivity

4

What does type 4 hypersensitivity mean?

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

5

What characterises sarcoidosis?

Multi-system involvement
Non-caseating granulomas
Unknown aetiology

6

What are some of the features of acute sarcoidosis?

Erythema nodosum
Uveitis
Bilateral hilar lymphadenopathy
Arthritis
Fever

7

What are some of the features of chronic sarcoidosis?

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

8

What are some differential diagnoses of sarcoidosis?

TB
Lymphoma
Carcinoma
Fungal infection

9

How is the diagnosis of sarcoidosis made?

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

10

What type of hypersensitivity reaction is extrinsic allergic alveolitis?

Type 3 hypersensitivity

11

What does type 3 hypersensitivity mean?

Immune complex mediated hypersensitivity i.e. involvement of antibodies

12

What kind of diseases does extrinsic allergic alveolitis include?

Bird fanciers lung
Malt workers lung
Farmers lung

13

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

Cough
Breathlessness
Myalgia
Pyrexia
Hypoxia
Crackles

14

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

Several hours after exposure

15

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

Progressive breathlessness and cough
Crackles

16

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

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

17

What is the treatment for EAA?

Removal of antigen
Oxygen in acute exacerbation
Steroids

18

What is the clinical presentation of idiopathic pulmonary fibrosis?

Progressive breathlessness
Dry cough
Finger clubbing
Fine inspiratory crackles bilaterally

19

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

Bilateral infiltrates

20

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

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

21

What treatment is available for idiopathic pulmonary fibrosis?

Lung transplant indicated for younger patients

22

Can idiopathic pulmonary fibrosis result in death?

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

23

What are some of the features of coal workers pneumoconiosis?

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

24

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

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