Non-infectious inflammatory diseases of the lung Flashcards Preview

Year 2 Respiratory > Non-infectious inflammatory diseases of the lung > Flashcards

Flashcards in Non-infectious inflammatory diseases of the lung Deck (33)
1

sarcoidosis

multisystem granulomatous inflammatory disease of unknown etiology

2

what are the risk factors for sarcoidosis (ethnicities, exposures)?

african americans
danes
swedes
exposure to insecticides, ag employment, microbial aerosols

3

what are the general manifestations / clinical presentation of sarcoidosis?

involvement of lymphatic and pulmonary system

dry cough, SOB

like TB without the infectious part

4

what is seen on PE with sarcoidosis?

adenopathy
skin lesions (lupus pernio, erythema nodosum)

5

what is seen on labs in sarcoidosis?

calcium levels
liver enzymes
creatinine

6

what ancillary tests should be performed for sarcoidosis?

ECG (for heart block)
opthalmologic
TB

7

what is seen on PFTs in sarcoidosis?

restrictive

decreased TLC
decreased VC
decreased RV
decreased DLCO

usually interstitial - limits expansion

8

what is the diagnostic procedure for sarcoidosis? what does it check for?

bronchoscopy to check for

BAL - lymphocyte, granulocyte count
CD4/CD8

9

when are systemic corticosteroids indicated for sarcoidosis?

cardiac involvement
ocular disease
neuro disease
hypercalcemia
lupus pernio
symptomatic stage II
stage III

10

what are the CT diseases that affect the lung?

RA
scleroderma
SLE
sjogren
dermatomyositic and polymyositis

11

what are the demographics and clinical features of RA that affects the lung?

male > female 50-60 yo
ILD 50%

12

what is the presentation for rheumatoid lung disease?

non productive cough
dyspnea on exertion
may precede joint disease by years
clubbing

13

what are the auscultatory findings of rheumatoid lung disease?

inspiratory fine crackles
pleural rub

14

what are the radiographic findings of rheumatoid lung disease?

nodules that can cavitate

15

what are the medications for rheumatoid lung disease?

methotrexate
etanercept
infliximab

16

what lab result is indicative of rheumatoid lung disease? why?

low glucose

bacteria are consuming the glucose

17

what are the two types of diffuse scleroderma lung disease?

interstitial lung disease
limited (CREST)

18

what is indicative of interstitial lung disease form of scleroderma on auscultation? what type of lung physiology is represented?

inspiratory crackles
restrictive lung physiology

19

what is seen in the limited (CREST) form of scleroderma?

pulmonary HTN
decreased DLCO

20

what is the most common presentation of SLE pulmonary involvement? what are other findings?

serositis

alveolar hemorrhage
diaphragmatic dysfunction
increased risk for DVT/PE** (hypercoagulable state)

21

what constitutes sjogren syndrome lung involvement?

airway compromise
bronchiestasis and bronchiolitis

22

what is a common manifestation of polymyositis / dermatomyositis pulmonary involvement?

aspiration pneumonia secondary to pharyngeal muscle weakness

23

what are the PFT findings for polymyositis / dermatomyositis?

restrictive

24

wegener's granulomatosis

what structures are involved?

necrotizing granulomatous vasculitis of small and medium vessels

upper and lower respiratory tract and kidneys

25

what are the symptoms / presentations of wegener's granulomatosis?

sinus symptoms
cough
hemoptosis
constitutional symptoms

26

which antibody is specific to wegener's syndrome?

cANCA

27

what is the diagnosis for goodpasture's syndrome?

presence of anti-glomerular base membrane antibodies

28

what is seen on bronchoscopy for goodpasture's syndrome?

persistent bloody fluid that does not clear on serial samples

29

how can diffuse alveolar hemorrhage present?

as the initial manifestation of a pulmonary vasculitis

30

what is the triad of churg-strauss syndrome?

asthma
hypereosinophilia
necrotizing vasculitis

31

what are the two phases of churg-strauss syndrome?

prodrome
eosinophilic

32

what is are the organ involvements in churg-strauss syndrome?

reversible airflow limitation
CV complications
GI - can be severe

33

what is seen on lab findings for churg-strauss syndrome?

eosinophilia (diagnostic)
elevated IgE
positive pANCA