interstitial lung diseases (causes), pleural & chest wall disease Flashcards
what are the structures affected in interstitial disease?
acini
alveoli lumen
bronchiolar lumen
bronchioles
what are the cells involved in interstitial disease?
epithelial endothelial mesenchymal macrophages recruited inflammatory cells
briefly describe obstructive lung disease, example?
can’t get air out as quickly - will get same volume out eventually e.g. COPD
briefly describe restrictive lung disease, example?
restrictive defect, slower to get air out but also less air out (both lungs affected)
interstitial lung disease
symptoms of interstitial lung disease?
shortness of breath
cough
both chronic symptoms - gradually getting worse over a year
onset over months & persistent
signs of underlying interstitial lung disease upon examination?
cyanosis
tachycardia
clubbing
signs of RHF - pulmonary & peripheral oedema, raised JVP (from pulmonary hypertension - pul arteries into lungs - cor pulmonar)
lung signs: tachypnoea, decrease chest movement, course crackles
what are the main causes of interstitial lung disease?
occupational treatment related CT disease immunological idiopathic
what are the occupational causes of ILD?
asbestosis
silicosis
coal workers pneumoconiosis
what are the treatment related causes of ILD?
radiation methotrexate nitrofurantoin amiodarone chemotherapy
what are the CT disease causes of ILD?
RA SLE polymyositis schleroderma Sjogren's
what are the immunological causes of ILD?
sarcoidosis
hypersensitivity pneumonitis
what are the idiopathic causes of ILD?
CFA / IPF UIP / NSIP DIP LIP RB-ILD BOOP
what is the most common idiopathic ILD?
idiopathic pulmonary fibrosis (IPF)
what is the age, survival, diagnosis & therapy for IPF?
60-80 yrs 3 year survival CT diagnosis therapy: pirifeuidone, nintedanib both treatment slow down progression, but toxic
what is the immunological sarcoidosis: age symptoms LFT biopsy differential diagnosis treatment
20-80 years asymptomatic, cough +/- rash LFT: normal / restrictive / obstructive / mix biopsy: non-caseating granuloma DD: TB, lymphoma treatment: none, steroids, methotrexate
