Interstitial Lung Disease DSA II Flashcards Preview

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Flashcards in Interstitial Lung Disease DSA II Deck (50)
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1

churg strauss syndrome

systemic necrotizing vasculitis
-upper and lower resp tracts

preceded by allergic disorders

peripheral and lung eosinophilia

IgE increase

rashes

2

CXR for churg strauss

bilateral patchy, fleeting infiltrates

diffuse nodular infiltrates

diffuse reticulonodular infiltrates

3

biopsy for churg strauss

granulomatous angiitis or vasculitis

4

Tx for churg strauss

corticosteroids

5

chronic eosinophilic pneumonia

pulmonary interstitium and alveolar spaces are infiltrated by eosinos and to lesser extent macrophages

6

clinical for chronic eosinophilic pneomonia

over weeks to months
-fever, weight loss, dyspnea, productive cough

pulmonary infiltrates with peripheral distribution

increased eosinophils in peripheral smear

BAL with increased eosinophils

7

Tx of chronic eosinophilic pneumonia

dramatic response to corticosteroids within days to weeks

therapy - prolonged for months - prevent recurrence

8

pulmonary alveolar proteinosis

primary path process affects alveolar spaces

filled with proteinacious phospholipid material
-components of surfactant

9

clinical for pulmonary alveolar proteinosis

dyspnea, cough, bilateral alveolar infiltrates

10

high res CT for pulmonary alveolar proteinosis

crazy paving pattern

thickened interlobular septa accompanied by groundglass alveolar filling

11

nocardia

superimposed resp infection

with pulmonary alveolar proteinosis

12

Tx for pulmonary alveolar proteinosis

whole lung lavage

good prognosis

13

whole lung lavage

gold standard treatment for pulmonary alveolar proteinosis

-saline into lungs with percussion to dislodge material in lungs

fluid then removed

repeated until no more material is recovered (when fluid is clear)

14

hypersensitivity pneumonitis

hyperimmune respiratory syndrome caused by inhalation of wide variety of allergic antigens that are usually rganic

bacteria, fungi, protozoa, animal proteins, reactive chemicals

15

Tx for hypersensitivity pneumonitis

avoid exposure

corticosteroids speed resolution

16

intermittent pulmonary and systemic symptoms, progressive interstitial CXR changes, non-resolving pneumonia

suspect hypersensitivity pneumonitis

agriculture, cattle farming, bird keeping, contaminated home ventilation, hot tubs

17

abrupt onset of cough, dyspnea, fever, chest pain, following heavy exposure to offending antigen, Sx 4-6 hours after exposure

subsides 24 hours after removal from exposure

acute hypersensitivity pneumonitis

18

gradula development of symptoms and less severe intensity

subacute hypersensitivity pneumonitis

19

insidious progressive dyspnea, cough, weight loss, fatigue, pulmonary fibrosis and resp failure

chronic hypersensitivity pneumonitis

20

thermophilic actinomycetes

moldy hay, grain, silage - farming - dairy cattle

hypersensitivity pneumonitis

also from ventilation - water-related contamination
-humidifier, hot tub, air conditioner

21

mycobacterium avium intracellular complex

hypersensitivity pneumonitis

from ventilation and water-related contamination

22

CXR for hypersensitivity pneumonitis

acute disease
-diffuse reticulonodular infiltrates

chronic disease
-diffuse interstitial fibrosis

23

high res CT for hypersensitivity pneumonitis

ground glass opacities early

chronic - with traction bronchiectasis, honeycombing, and fibrosis

24

PFT for hypersensitivity pneumonitis

restrictive, small lung volume, decreased diffusion capacity

25

sarcoidosis

systemic granulomatous disease
-non-caseating granuloma

can effect any organ

unknown etiology

age 40-60yo
-peak 20-40yo

3.5x higher than african americans

more in women

26

sarcoidosis

pulmonary not necessary for Dx

abnormal CXR with mediastinal and hilar adenopathy

may lead to chronic disease
-pulmonary fibrosis

27

lofgrens syndrome

acute manifestation of sarcoidosis

-erthyema nodosum
-arthritis
-bilateral hilar lymphadenopathy

favorable prognosis

28

fatigue, night sweats, fever, weight loss, cough, dyspnea, wheeze, rash, macules, hyper/hypopigmentation, erythema nodosum, dry eyes, pain, redness, blurry vision, arrhythmia, palpitations, syncope, HAs, numbness, epigastric pain, RUQ pain, jaundice, swelling and joint stiff, muscle pain, nasal congestion, sinus pressure

sarcoidosis

29

rales, exp whezing, infiltration of old scars/tattoos, macolopapular lesions, erythema nodosum uveitis, iritis, scleral plaque, irregular cardiac rhythm, CN II, VII, VIII neuropathies, hepatomegaly, arthritis, palpable adenopathy

sarcoidosis

30

lupus pernio

affect nose, cheeks, ears in sarcoidosis