Interstitial lung disease Flashcards Preview

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Flashcards in Interstitial lung disease Deck (41):
1

course idiopathic pulmonary fibrosis

end stage lung, cor pulmonale

2

mesothelioma, arises from ____,
when?

arises from mesothelial cells of pleura 25-40 years after exposure

no relationship to smoking

2

bronchogenic carcinoma

in asbsetos related disease

additional risk with smoking 

20 years after first exposure

2

complications asbestos related diseases

cor pulmonale

caplan syndrome

3

Caplan syndrome of complicated coal worker's pneuoconiosis

CWP with rheymatoid nodules

4

histo coal worker's pneuoconisis

antrascosis black pigment

fibrous opacity with pink fibrous tissue

4

types of hyeprsensitivity pnuemonitis

famers lung - themophilic actinomycetes bacteria saccharopolypora rectivirgula

silo fillers disease - plant material gases

Byssinosis - textile workers

5

clinical and laboratory findings intersitital lugn

dry cough

dypsnea

late inspiratory crackles, bibasilar

cor pulmonale

CXR - bilateral reticulondular infiltrates

6

____ pigment in coal worker's pneumoconiosis

antrhacotic pigment

7

exposure progression in hypersensitivity pneumonitis

first exposure - IgG in serum

second - antibodies > immune complexes >interstital inflammation

chornic exposure: glanuloma formation (type IV response)

8

CXR and histo idiopathic pumonary fibrosis

increased interstitial markings (fibrosis) in lower zones

honeycomb cysts

fibroblasctic plugs

9

hypersensitivity pneumonitis

inhaled antigen producing granulomatous interstitial pneumonitis

10

pathology SLE interstitial lung disease

peleual effusion (young woman with effusion = sle)

11

presentation sarcoidosis

Skin: nodular granulomatous lesions, lupus pernio, erythema nodosum

Eye: uveitis

liver: granulomatous hepatitis

other: enlarged salivary and lacrimal glands, Diabetes insipidous, Bone marrow and spleen involvement

12

pathogenesis idiopathic pumonary fibrosis

repeated injury > alveolitis > cytokine release > interstitial fibrosis

13

pathogenesis sarcoidosis

disorder of immune regulation

antigen > CD4 interaction > cytokines > monocytes+histiocytes recruited > non-necrotizing granumloma formation

13

infiltrate of farmer's lung hypersensitivitiy penumonitis

thermophilinic actinomycetes - saccharopolyspora rectivirgula

14

berylliosis tissue reaction

 

site of acquirement

granulomatous inflammation

 

nuclear and airspace industry (beryllium)

15

complications silicosis

cor pulmonale

caplan syndrome (rheumatoid nodules)

increased risk for TB (silicotuberculosis) and cancer

16

CXR sarcoidosis

bialteral hilar adenopathy

reticulonular shadows in lungs

17

interstitial granuloma distribution in sarcoidosis

 

other histo

lympathic distribution pattern

 

langhans giant cells

epitheliod histiocytes

19

simple coal workers pneumoconiosis vs complicated

progressive massive fibrosis

20

histo complicated coal worker's penumoconiosis

fibrous opacities > 1cm

with/without central necrosis

massive fibrosis

caplan syndrome (rheumatoid nodules)

(no increased incidence of TB or cancer)

21

distribution of fibrous opacities in simple coal workers pneumoconiosis

upper lobes and upper-lower lobes

coal dust adjacent to respiratory bronchioles

23

aveolitis =

damage to pneumocytes and endothelial cells

24

in anthracosis, anthracotic pigment found in 

intersitial compartment and lymph nodes

25

pathology systemic sclerosis (scleroderma) interstitial lung disease

interstitial fibrosis

pulmonary vascular hypertrophy

(commonest casue of death in these patients)

26

histo hypersensitivity pneumonitis

intersitital and alveolar inflammatory cell infiltrates

peri-bronchilar accentuation

ill-defined granulomas

(biopsy may be needed)

27

two forms of asbestos

serpentine

amphibole - straight and rigid

28

tissue appearance asbsestos related disease

deposits in respiratory bronchioles, ducts and alveoli

ferringinous boides - macrophages, fibers coated with ferritin (iron and protein)

benign pleural plaques

diffuse interstital fibrosis

29

collagen vascular diseases seen in interstitial lung disease

SLE (50% have interstiial lung)

RA

systemic sclerosis (scleroderma)

30

demographics sarcoidosis

AA:whites 10:1)

F:M 2:1

70%< 40 years

non smokers

31

most common occupational disease 

silicosis

33

pathogenesis silicosis

quartz activates macrophages > cytokines > fibrogenesis

34

pathology RA interstitial lung disease

rhematoid nodules (caplan syndrome+pneumoconiosis)

interstitial fibrosis,

pleural effusion

35

distribution of particles in pneumoconiosis

1-5um particles reach bifurcation of bronchioles and alveolar ducts

36

lab findings sarcoidosis

increased ACE levels

hypercalcemia

polyclonal gammopathy

cutaneous anergy - no response to skin antigens(CD4 consumed)

38

pneumoconioses =

non-neoplastic lung disease in response to inhalation of mineral dust

39

types of interstitial lung disease

ARDS

Fibrosing lung disorders (pneumoconioses)

Granulomatous disorders (sarcoidosis)

idiopathic interstitital pneumonias

40

multisystem granulomatous disease of unknown etiology

sarcoidosis

41

end stage interstitial fibrosis (seen in idiopathic pulmoanry fibrosis)

hito

honeycomb lung (irregular dilatation of adjacent airwaus due to interstitial fibrosis)