Interstitial lung disease Flashcards Preview

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Flashcards in Interstitial lung disease Deck (34)
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1
Q

What is ILD?

A

Any disease process affecting the lung interstitial (alveoli, terminal bronchi)
It interferes with gas transfer

2
Q

What type of pattern do ILD’s have?

A

Restrictive lung pattern

3
Q

What are the usual symptoms of ILD?

A

Breathlessness and dry cough

4
Q

What is sarcoidosis?

A

A multisystem granulomatous (type 4 hypersensitivity) disorder, commonly affecting young adults, more common in african-caribbean women.

5
Q

what systems can be involved?

A

Its multi-system so any
Common - lung, lymph nodes, joints, liver, eyes
Uncommon - Kindeys, brain, nerves, heart

6
Q

Is it a caseating or non-caseating granulomatous disease?

A

A non caseating granuolma of unknown atieology

7
Q

Is it more or less common in smokers?

A

Less common in smokers

8
Q

What are the symptoms of sarcoidosis?

A
Erythema nodusum 
Dry cough, progressive dyspnea 
Chest pain 
Fatigue 
Weight loss
Fever
Uveitis
9
Q

What might be seen on an XRAY?

A
Bilateral Hilar lymphodenpathy 
Depending on the degree of severity you may also see....
BHL with pulmonary infiltrates
Just pulmonary infiltrates 
Fibrosis
10
Q

What would you see in a blood test in sarcoidosis?

A

ACE levels increased (activity marker not diagnostic)
Raised calcium
Increased inflammatory markers

11
Q

What might you see in a tissue biopsy of sarcoidosis?

A

Non-caseating granuloma

12
Q

What is the treatment of sarcoidosis?

A

Acute - usually self limiting

Chronic - oral steroids, immunosuppression

13
Q

What is extrinsic allergic alveolis (Hypersensitivity pneumonitis)

A

Type 3 hypersensitivity reaction. Widespread diffuse inflammatory reaction in the small airways and alveoli due to inhalation of foreigns antigens usually from animals.

14
Q

What are the causes of EAA?

A
Famers lungs 
Bird and pigeon fanciers lung 
Malt workers lung 
Mushroom workers lung 
Sugar/bagassosis workers lung
15
Q

What are the symptoms of EAA?

A

Cough, breathlessness, fever
coarse end inspiratory crackles (no wheeze)

can be acute or chronic

16
Q

When might chronic EAA occur?

A

When there has been lose dose antigen exposure over a long period of time

17
Q

What might you see in a CXR of acute and chronic EAA?

A

Acute - pulmonary infiltrates widespread

Chronic - pulmonary fibrosis (upper zones)

18
Q

What might you see in the lung function tests of acute and chronic EAA?

A

Acute - reversible restrictive

Chronic - Persistent changes

19
Q

What is the treatment for acute and chronic EAA?

A

Acute - Remove allergen, give O2, oral prednisolone.

Chronic - avoid exposure to antigen, long term oral steroids.

20
Q

What is idiopathic pulmonary fibrosis? (IPF)

A

Rare, more common in males.

Progressive decline in lung function. Inflammatory cell infiltrate and pulmonary fibrosis of unknown cause.

Most common interstitial lung disease.

21
Q

What are the symptoms of IPF?

A

Dry cough, exertional dysponea
Malaise, weight loss, joint pain
progressive breathlessness

Clubbing

22
Q

What would you hear on auscultation of IPF?

A

Bilateral fine inspiratory crackles

23
Q

What might you see on the CXR of IPF?

A

Ground glass appearance

Honeycomb lung

24
Q

What is the treatment for IPF?

A

Pirfenidone - new anti-fibrotic drug (expensive and side effects)
Oxygen if hypoxic
Lung transplant in young patients

25
Q

Describe coal workers pneumoconiosis?

A

Dust particles are retained in the small airways and alveoli of the lung for usually over 15-20 yrs.

26
Q

What are the 2 different types of syndromes you can get with coal workers lung?

A

Simple pneumoconiosis - most common, deposition of coal dust in the lungs. Associated with COPD.

Progressive massive fibrosis - due to a progression of simple. Patients develop round fibrotic masses mostly ion upper lobes. Apical destruction of the lung, resulting in emphysema and airway damage.

27
Q

What are the symptoms of coal workers pneumoconiosis?

A

cough and black sputum

28
Q

What might you find on investigation?

A

Restrictie lung function tests

Rhematoid factors and ANAs +ive.

29
Q

What is the treatment of coal workers lung?

A

Avoid further exposure

30
Q

What is silicosis?

A

Caused by an inhalation of silica particles which are very fibrogenic. Distinctive streaks of thin calcification may be seen around hilar lymph nodes (Eggshell calcification)

31
Q

What would be seen on the CXR of someone with silicosis?

A

Egg shell calcification of hilar nodes

(small numerous opacities in upper lung zones with hilar lymphadenopathy

32
Q

Describe asbestosis?

A

Fibrosis causes by asbestos dust exposure
White (chrysotile) is the least fibrogenic
Blue (Crocidolite) is the most fibrogenic

33
Q

What are some of the symptoms and signs of asbestosis?

A

Plerual plaques
Progressive breathlessness
Clubbing
Bilateral basal fine end inspiratory crackles

34
Q

What are some of the complications of asbestosis?

A

Bronchial carcinoma, Pulmonary fibrosis, adenocarcinoma…. etc