Flashcards in Interstitial Lung Disease Deck (27):
This is the most common cause of interstitial lung disease?
Idiopathetic pulmonary fibrosis
Pathophysiology of ILD?
Lung sustains an injury. Due to exhausted resources or imperfect repair system, the injury is retained. ILDs can involve excess collagen deposition into the interstitium and surrounding tissues. This leads to fibrotic tissue deposition in the lung and impaired capillary gas exchange.
Clinical presentation of ILD?
Dyspnea on exertion that is progressive, non productive dry cough, pleuritic chest pain
Physical exam findings of ILD?
Coarse crackles, wheezing IS NOT common, clubbing of finger nails if in severe stage, cyanosis
Diagnostic testing for ILD?
CXR, high resolution CT scan (HRCT), pulmonary function testing (PFT)
This will be present on PFT of ILD?
Restrictive patterns, decrease in TLC.
Pathogensis of idiopathic pulmonary fibrosis?
Fibrosis of parenchyma of lungs. Thought to be a result of aberrant promotion of fibroblast and subsequent collagen deposition of epithelial surfaces. Fibrosis spreads from alveoli to alveolar lumen and adjacent lung parenchyma
Physical exam findings for IPF?
MAY reveal crackles, clubbing, cyanosis, pulm HTN, pedal edema, holosystolic tricuspid regurg murmur
Findings on CXR? Finding on CT
CXR: opacities and densities, especially lower lobs with loss of volume. CT: Honeycombing
These values would indicate oxygen therapy?
Sarcoidosis is a systemic disease that involves?
formation of granulomas, found commonly in the tissues of lungs and lymph nodes of throacic region
Having a first degree relative with sarcoidosis increases your risk this much?
5 fold. Genetics likely play a role
Clinical manifestation of sarcoidosis?
Dyspnea, cough, chest pain. Fatigue, night sweats, weigh loss can occur
Sarcoidosis can eventually progress to?
ENT presentation of sarcoidosis
anosmia, erosion of cartilage nasal septum, deformity, stridor, dysphonia, dysphagia and cough
Dermatologic presentation of sarcoidosis?
Maculopapular lesions w/ red/violaceous appearance
Why would you test serum ACE levels?
sarcoid granulomas produce angiotensin converting enzyme but only elevated in 60% of sarcoid patients.
Most conditions of sarcoidosis are treated with?
Unlike other ILD, fibrotic lesions are reversible in this disease?
Cryptogenic organizing pneumonia (COP)
Clinical presentation of crypgenic organizing pneumonia
cough, dyspnea, malaise, fever. onset is typically weeks to months, weight loss of greater than 10lbs in over 50%
bilateral consolidation that can be patchy or diffuse
CT scan on COP
Patchy opacities are more frequently found in periphery of lung fields in lower portions of lungs
These are higher in COP than IPF?
Lymphocytes, neutrophils, eosinophiles
Treatment of COP depends on?
Sever or progressing COP treatment?
If patient failed steroids, cyclophosphamide. May also need macrolide antibiotic
Mild to moderate COP treatment?
Macrolide therapy: Clarithromycin 250-500mg BID 3-6 months