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Flashcards in Overview of Disease Deck (36):
1

Asthma

eosinophillic, chronic inflammation of the large and small airways which is reversible

2

COPD

result of smoking - obstructive disease neutrophillic

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Atopy

allergy

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Airway Remodelling

as a result of chronic inflammation in the airway

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Eosinophils

a white blood cell containing granules that are readily stained by eosin.

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Neutrophils

most abundant type of granulocytes

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Macrophages

a large phagocytic cell

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Diurnal variability

variations between morning and night

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Bronchodilator reversibility

The reversibility of the an airway disease by a bronchodilator

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Chronic Bronchitis

neutrophillic inflammation

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Emphysema

a form of COPD

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Cor Pulmonale

condition that most commonly arises out of complications from high blood pressure (pulmonary hypertension). It's also known as right-sided heart failure

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ACOS

Asthma and COPD overlap syndrome - more responsive to to steroids

14

DPLD

Diffuse Parenchymal Lung Disease

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What is the DPLD?

A restrictive thoracic disease - a disease of alveolar structures

Causes issues in gas exchange

There is fluid in the alveolar air spaces

CO2 not affected as ventilation is normal 

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What is the primary abnormality in DPLD?

hypoxia --> impaired gas exhange 

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What are the causes of DPLD?

Cardiac Pulmonary Oedema

Non-cardiac - i.e. sepsis or trauma causing leaking pulmonary capillaries 

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Causes of DPLD (3)

Infective Disease 

Infarction

Other disease such as Autoimmune Rheumatoid, BOOP 

 

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Granulomatous Alveolitis

Collection of inflammatory cells

Extrinsic Allergic Alveolitis

Sarcoidosis

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Extrinsic Allergic Alveolitis

Hypersensitivity Penumonitis Type 3 reaction

Farmers Lung - mouldy hay, granulomatous 

Avian - bird allergens

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Causes of drug induced alveolitis (4)

Amiodarone 

Bleomycin

Methotrexate

Gold

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Toxic Gas Fumes which cause alveolitis

Chlorine

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Causes of fibrosing alveolitis

Rheumatoid 

Cryptogenic

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Auto-immune causes of Alveolitis

Systemic Lupus Eryhtmitis

Wegners 

Churg-Strauss

Bechet's 

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Another word for dust-disease

pneumoconiosis

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Fibrogenic dust-disease (alveolitis)

asbestosis

silicosis

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Non-fibrogenic dust disease (alveolitis)

Siderosis (Iron)

Stanosis (Tin)

Baritosis (Barium)

28

Eosinophillic causes of DPLD

Drugs - nitrofurantoin 

Fungal - aspergillis 

Parasites - toxocara, ascaris, filaria

Autoimmune - churg strauss, polyarteritis

 

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Clinical Presentation of DPLD (6)

  1. Breathless on exertion
  2. Cough but no wheeze
  3. Finger Clubbing
  4. Inspiratory Lung Crackles
  5. Central cyanosis
  6. Pulmonary fibrosis occurs as end stage response to chronic inflammation

30

DPLD Diagnosis from:

History

Lung Volumes

Gas Diffusion

Arterial Oxygen

History - pets, occupation, drugs, arthritis

Lung Volumes - FEV1 and FVC decreased - normal ratio

Peak Flow Normal

Reduced Gas Diffusion TLCO

Decreased PaO2 and SaO2 at rest or exercise

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1st Line Treatment of DPLD

Systemic corticosteroids 

inhaled steroids are not effective

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2nd Line treatment of DPLD

oral Azahioprine 

Anti-fibrotic agents - Pirfenidone, Nintedanib

Anti-oxidant agents - Acetylcysteine 

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What is the last resort treatment for end stage DPLD?

Lung transplant

34

This is _______ ________ caused by sarcoidosis

Q image thumb

Erythema Nodosum

35

What is shown here?

Q image thumb

Bilateral hilar lymphadenopathy 

Sarcoidosis

36