Interstitial Lung Diseases Flashcards
(75 cards)
respiratory disease stress is common in…
(aka hyaline membrane disease)
preterm infants
Cause of RDS?
deficiency of surfactant in immature lung –> makes gas exchange difficult
Infants with RDS usually present within…
minutes to hrs after birth, worsens over 1st 48 hrs of life
Signs of RDS
tachypnea, nasal flaring, expiratory grunting, retractions, cyanosis
decreased BS, pale, decreased peripheral pulses, low UOP, peripheral edema
Clinical course of RDS
uncomp RDS usually progressd 48-72 hrs & improves as endogenous surfactant production is increased
exogenous surfactant dramatically improves pulm func. -> sxs resolve -> shorter course
CPAP also improves clinical course
CXAY of pt with RDS?
low lung volume
classic reticulogranular ground glass appearance with air bronchograms
ABG in pt with RDS typically shows…
hypoxemia that responds to O2
as disease progresses, may see hyponatremia due to water retention
In RDS diagnosis is…
clinical, must distinguish from other causes
How can we prevent RDS?
prevent pre-term birth when possible
Antenatal steroids given to all women 23-34 wks gestation at risk of preterm delivery in the next 7 days
Management of RDS?
nasal CPAP
or Intubation + surfactant therapy + mechanical ventilation
How is ARDS different from RDS?
ARDS is acute respiratory distress syndrome in adults, is an acute, diffuse, inflammatory lung injury that leads to:
- decreased pulmonary vascular permeability
- increased lung weight and loss of aerated tissue-assoc. w/ high mortality rate
caused by direct or indirect injury to the lung
What are the 4 clinical syndromes that can be caused by Non-TB mycobacteria infections (NTM)?
- pulmonary disease (esp. in older pts with cystic fibrosis
- superficial lymphadenitis
- Disseminated disease (in severely immunocompromised)
- skin and soft tissue infection
Main cause of NTM lung infections?
MAC (mycobacterium avium complex)
these organisms are acquired from the environment
Signs/sxs of MAC pulmonary disease?
looks like TB but less severe and often indolent
-fatigue, malaise, weakness, cough, dyspnea, chest discomfort
lung exam often norm
MAC clinical presentation in those with underlying lung disease?
-white, middle aged or elderly men often alcoholics and/or smokers with underlying COPD
resembles TB clinically &radiographically but usu. less severe
MAC clinical presentation in those w/p lung disease
non smoking women >50 y/p who have interstitial pattern on CXR
How do you dx MAC pulmonary disease?
consistent CXR
positive sputum culture x 2
other dx have been excluded
What is bronchiectasis?
chronic condition where walls of the bronchi are thickened from inflammation and infection
Do you always need to tx MAC pulmonary disease?
NO, anti-myobacterial drugs can be dif. to tolerate
If fibrocavitary disease > TREAT
if nodular bronchiectasis > depends on presentation/status of pt
What abx should you give to a pt with MAC pulmonary disease?
depends on susceptibility
usually: Azithromycin + Rifampin + Ethambutol
for usually 15-18 months (tx until cultures -)
Interstitial lung disease aka…
pulmonary fibrosis
What is interstitial lung disease?
includes variety of chronic lung disorders
nonmalignant/noninfectious but serious
How is the lung affected in ILD?
- lung parenchyma is damaged
- walls of the alveoli become inflamed
- Scarring (fibrosis) begins in the interstitium and the lung becomes stiff
Causes of ILD?
diseases (sarcoidosis, neurofibromatosis), exposures (asbestos), drugs (Macrobid), Idiopathic
