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Lung Disease Flashcards

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1
Q

what is interstitial lung disease

A

any disease process affecting lung interstitium (tissue and space around air sacs i.e. alveoli, terminal bronchi)

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2
Q

what does ILD interfere with

A

gas transfer

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3
Q

what type of lung pattern does interstitial lung disease produce

A

restrictive

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4
Q

what are the symptoms of ILD

A

breathlessness dry cough

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5
Q

what are the three types of interstitial lung disease

A

acute, episodic, chronic

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6
Q

describe the three main factors of chronic lung disease

A

part of systemic disease, exposure to agent, idiopathic

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7
Q

describe sarcoidosis- immunologically, it causes and the systems it invloves

A

granulomatus; type 4 hypersensitivity, non caseating granulomas, multisystem involvement; lungs, lymph nodes, joints, liver, skin. idiopathic

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8
Q

what are the two types of sarcoidosis

A

acute, chronic; lung infiltrates- alveolitis

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9
Q

what are the differential diagnosis of sarcoidosis

A

TB, lymphoma, carcinoma, fungal infection

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10
Q

how is sarcoidosis diagnosed

A

CXR and CT scan- if not blood test

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11
Q

how is acute sarcoidosis treated

A

self limiting, steroids if vital organ affected

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12
Q

how is chronic sarcoidosis treated

A

with oral steroids- sarcoidosis very sensitive to steroids, immunosupression

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13
Q

what needs to happen after the treatment of sarcoidosis

A

monitor chest x-ray and pulmonary function for several year- often relapses

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14
Q

what are the symptoms of sarcoidosis

A

small patches of red and swollen skin, usually affects lungs and skin

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15
Q

what eye condition can be caused by sarcoidosis what how is it treated

A

uveitis, steroid drops

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16
Q

describe the histology of sarcoidosis

A

non-caseating, multinucleated giant cells

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17
Q

what is extrinsic allergic alveolitis a form of

A

hypersensitivity pneumonitis, type 3 hypersensitivity

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18
Q

what are the two forms of extrinsic allergic alveolitis

A

acute and chronic

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19
Q

what are the symptoms of acute E.A.A

A

cough, breathless, fever, myalgia

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20
Q

how is acute E.A.A treated

A

oxygen, steroid and antigen avoidance

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21
Q

describe chronic E.A.A

A

repeated low odse antigen exposure over time

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22
Q

what are the symptoms of chronic E.A.A

A

progressive breathlessness and cough, maybe crackles

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23
Q

what will an x ray show in chronic E.A.A

A

CXR show pulmonary fibrosis, commonly in upper lung

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24
Q

what will a PFT show in chronic E.A.A

A

restrictive defect ( low FEV1 and FVC, high/normal ratio, low gas transfer)

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25
how is chronic E.A.A treated
remove antigen exposure, oral steroids
26
what might a CXR show in sarcoidosis
bilateral hilar lymphadenopathy or enlargement and lung infiltrates
27
what is the most common form of ILD
idiopathic pulmonary firbrosis
28
is idiopathic pulmonary fibrosis an inflammatory condition
no
29
what is thought to cause IPF
imbalance of fibrotic repair system, related to gastric reflux, more common in smokers
30
what are the secondary causes of IPF
rheomatoid, asbestos, drugs
31
what is the clinical presentation of IPF
progressive breathlessness over many years, dry cough, clubbing, bilateral inspiratory crackles,
32
how does IPF show on a PFT
restrictive defect, low gas transfer
33
how does IPF show on a CXR
bilateral infiltrates, interstitial scarring
34
how does IPF show on a CT scan
reticulonodular fibrotic shadowing, worse at bases and periphery. traction bronchiectasis, honey-combing cystic changes
35
how is IPF diagnosed
history (ask about occupation), examination and radiology tests
36
what needs to be done is presentation is atypical
lung biopsy
37
describe the pathology of IPF
interstitial pneumonia pattern, heterogeneous fibrosis in alveolar walls causing honey-combing
38
how is IPF treated
anti firbrotic treatments slow progress do not reverse- pirfenidone and nintedanib
39
when are steroids used to treat IPF
never, only work with inflammatory ILD
40
what is coal workers pneumoconiosis
simple pneumoconiosis (restrictive lung disease cause by inhalation of dust)
41
what is complicated pneumoconiosis
progressive massive firbosis
42
what causes chronic bronchitis
coal dust + smoking
43
what is chronic bronchitis
inflamed bronchial tubes with excessive mucous production
44
what is caplans syndrome and what causes it
rheumatoid pneumoconiosis- when a patient with rheumatoid arthritis gets exposed to coal dust and gets cavitating nodules in lung
45
what is rheumatism
inflammation and pain in the joint
46
what does an CXR of simple coal workers pneumoconiosis
abnormality- miliary dots, shadows
47
what symptoms does simple (coal workers) pneumoconiosis present
none- risk of developing complication later
48
what causes silicosis
15-20 years exposure to quartz (mining, glass workers, boiler workers, foundry workers)
49
what does a CXR of silicosis show
eggshell calcification of hilar nodes
50
how is chronic silicosis characterised
restrictive pattern, pulmonary fibrosis
51
what does a CXR of a simple pneumconiosis (silicosis) show
miliary nodular appearance
52
describe progressive massive fibrosis
balls of fibrous tissue that grow and engulf the lungs
53
what does exposure to barium cause
baritosis
54
describe asbestosis
pulmonary fibrosis due to heavy, prolonged exposure to asbestos
55
what are the 4 pleural diseases relating to asbestos
benign pleural plaques (asymptomatic) acute asbestos pleuritis (fever, pain, bloody pleural effusion), pleural effusion and diffuse pleural thickening (restrictive impairment), malignant mesothelioma (incurable pleural cancer)
56
what are the presenting symptoms of malignant mesothelioma
chest pain and pleural effusion
57
what is pleural effusion
build up of fluid in pleural space
58
what does asbestos multiply the risk of in smokers
bronchial carcinoma
59
how do fibrous cause fibrosis
cause abnormal behaviour in macrophages and fibres laid down
60
what is pulmonary interstitium
alveolar lining cells (type 1 and 2), thin elastic-rich connective component containing capillary blood vessels
61
describe the effect of early stage alveolitis on the alveolar walls
injury with inflammatory cell infiltration
62
what is acute ILD exemplified by
adult respiratory distress syndrome
63
what is late stage interstitial lung disease characterised by
fibrosis
64
what do patients with ILD present with
clinical effects due to hypoxia- respiratory failure and cardiac failure. Also seen on radiology
65
what can cause interstitial lung disease
environment (minerals, drugs, radiation- HYPERSENSITIVITY), unknown- idiopathic (connective tissue diseases, idiopathic pulmonary fibrosis)
66
what is idiopathic pulmonary fibrosis
progressive fibrotic disease
67
what types of biopsy used to diagnose interstitial lung disease
transbronchial, thoracoscopic more invasive but more reliable
68
what conditions are associated with chronic interstitial lung disease
idiopathic pulmonary fibrosis, sarcoidosis, extrinsic allergic alveolitis (hypersensitivity pneumonitis), pneumoconiosis, connective tissue diseases
69
what symptoms are associated idiopathic pulmonary fibrosis
progressive interstitial fibrosis, variable associated inflammation, finger clubbing
70
what is sub pleural
between the pleura and body wall
71
describe the pathology of lungs during idiopathic pulmonary fibrosis
subpleural and basal fibrosis, terminal structure replaced by dilated spaces surrounded by fibrous walls, alveolar walls thickened
72
how does idiopathic pulmonary fibrosis affect gas exchange
impaired due to thickened alveolar walls
73
what is associated with late stage idiopathic pulmonary fibrosis
honeycombing
74
what are parts of the airway involved with chronic inflammatory disease
small airways, interstitium
75
describe inflammatory interstitial expansion and what it leads to
when tissue expanded by inflammatory tissue (not fibrosis). will eventually lead to fibrosis and scarring if inflammation persists
76
what is EAA
extrinsic allergic alveolitis
77
what causes inflammatory interstitial expansion
extrinsic allergic alveolitis
78
what is sarcoidosis
multi system granulomatous disorder of unknown cause
79
what immune response leads to granuloma formation
type 4 ( t cell mediated)
80
what are the other manifestations of sarcoidosis
uveitis, erythema nodosum, lymphadenopathy, hypercalcaemia (abnormal calcium metabolism)
81
what eventually happens to granulomas in interstitial lung disease
calcify
82
what connective tissue diseases affect the lungs
intersitial fibrosis, pleural effusions, rheumatoid nodules (can form in the lungs)
83
what is milder, idiopathic pleural fibrosis or interstitial fibrosis
interstitial
84
what is a differential diagnosis for rheumatoid nodules
TB
85
what is pneumoconiosis
group of occupational (restrictive) lung diseases caused by mineral dust exposure
86
name three forms of pneumoconiosis
asbestosis, coal workers lung, silicosis
87
what is the lungs reaction to inhalation of coal dust
fibrosis
88
what are the pathological features of coal miner lung
pigmentation, fibrosis, scarring and nodular scarring
89
what does pneumoconiosis dependant on
particle size, reactivity of particle, clearance of particle, host response
90
which shape of asbestos are most dangerous
straight
91
what results from the inhalation of asbestos
parietal pleural plaques, interstitial fibrosis (asbestosis), bronchial carcinoma, mesothelioma

Respiratory (26 decks)

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