In what percentage of patients does progressive TB occur?
Less than 10% of all TB patients, usually immunosuppressed
What are some DDx of bilateral hilar enlargement?
Other infections - fungal
What is honeycomb lung?
Irreversible end-stage manifestation of a large number of interstitial inflammatory and proliferative lung diseases
What is the pathogenesis of an exudate?
Altered permeability of or damage to the capillaries surrounding space
What are some non-infectious causes of pleuritis?
Connective tissue disorders: eg RA or lupus
What is a common cause of mesothelioma?
What is sarcoidosis?
Most common interstitial lung disease
What is a common first presentation of mesothelioma?
What type of TB typically occurs at the apex of the lung?
What are common causes of interstitual lung disease?
What is secondary TB?
Reactivation of a dormant focus of primary TB
or a new infection
What is the pathophysiology of mesothelioma?
Small fibres in the alveolar causes chronic stimulation > tumour develops
What is granulomatous inflammation?
Nodular clusters of macrophages +/- giant cells
What is the commonest cause of non-necrotising granulomas?
What are differentials for granulomatous inflammation?
What is Gohn's complex?
Gohn focus - TB lesion in the lung parenchyma
TB Lesion in a draining LN
What must you do before treating sarcoidosis?
Exclude infective causes as steroids will likely exacerbate the sarcoidosis
What is the prognosis of mesothelioma?
Average survival from onset of symptoms is 12-15 months
Mortality is 100%
What causes a chylous effusion?
High lymphocyte count - TB, lymphoma
How much fluid accumulation consitutes a pleural effusion?
Typical presentation of interstitial lung disease?
Slow, increasing SOB
What is usual interstitial pneumonia?
Idiopathic pulmonary fibrosis
Cryptogenic fibrosing alveolitis
How do you differentiate adenocarcinoma with mesothelioma?
What is the difference between a transudate and exudate?
Transudate is lower in protein
What is the pattern of location of sarcoidosis?
Enlarged lymphadenopathy at the hilum
Bilateral granulomatous inflammation of lungs
What is the main differential for mesothelioma?