parenchymal lung disease Flashcards
(74 cards)
1
Q
another name for parenchymal lung disease
A
interstitial lung disease
2
Q
what are they characterised by
A
- inflammation
- fibrosis
3
Q
where does it affect initially
A
interstitium of lung
4
Q
what does it present with
A
- exertional dyspnoea
- maybe cough
5
Q
granulomatous diseases
A
- sarcoidosis
- hyperesensitivity pneumonitis
- infections e.g. TB
6
Q
what is most common cause of ILD
A
idiopathic pulmonary fibrosis
7
Q
what is the cause of IPF
A
unknown
8
Q
when is IPF onset
A
sixties
9
Q
who is more likely to get IPF men or women
A
men
10
Q
what is histological finding in IPF
A
interstitial pneumonia
11
Q
what is seen in lung pathology of IPF
A
- marked fibrosis
- honeycombing
12
Q
what happens to elasticity of lung in IPF
A
there is a loss
13
Q
where can TB affect
A
anywhere
14
Q
symptoms of IPF
A
- progressive dyspnoea
- cough
- mucus (sometimes)
- finger clubbing
- bi-basal end inspiratory crackles
15
Q
spirometry results in IPF
A
restrictive
16
Q
what is done to diagnose IPF
A
CT
17
Q
what does CT show in IPF
A
- basal distribution
- subpleural reticulation
- traction bronchiectasis
- honeycombing
18
Q
how does honeycombing show in CT
A
cystic airspaces with irregularly thickened walls
19
Q
when is bronchoalveolar lavage done for IPF
A
in infective or malignant cause suspected
20
Q
differential diagnosis for IPF
A
- interstitial pulmonary oedema
- infection
- lymphangitis carcinomatosa
21
Q
what is survival rate for IPIF
A
2-5 years
22
Q
treatment of IPF
A
- pirfenidone
- nintedanib
23
Q
what is pirfenidone
A
an antifibrotic agent
SE: rash
24
Q
what is nintedanib
A
inhibitor of tyrosine kinases
25
what causes hypersensitivity pneumonitis
allergic reaction affecting the small airways and alveoli
26
what are the causes of hypersensitivity pneumonitis
- farmers
- bird fanciers
- maltworkers
- humidifier
- mushroom worker
- cheese washer
- winemaker
27
what is most common cause of hypersensitivity pneumonitis
farmer lung
28
histological findings of hypersensitivity pneumonitis
- chronic inflammatory infiltrate
- poorly defined interstitial granulomas
- interstitial fibrosis and honeycomb
29
symptoms of hypersensitivity pneumonitis
- malaise
- dyspnoea
- cough
- weight loss
- inspiratory squeaks
- fine crackles
30
when do symptoms present for hypersensitivity pneumonitis
4-6 hours after exposure
31
what does CT show in hypersensitivity pneumonitis
ground glass appearance
32
what is spirometry in hypersensitivity pneumonitis
restrictive
33
what can bronchoalveolar lavage good in hypersensitivity pneumonitis
to differentiate between sarcoidosis
34
treatment of hypersensitivity pneumonitis
- avoidance of exposure
| - prednisolone
35
does fibrosis resolve
no
36
what causes humidifier fever
- humidifiers
| - air conditioning units
37
what is langerhans cell histiocytosis characterised by
proliferaiton of langerhans cells
38
what is langerhans cell histiocytosis associated with
smoking
39
what does CT show in langerhans cell histiocytosis
- interstitial thickening
- nodules
- cysts
- honeycombing
40
treatment for langerhans cell histiocytosis
- smoking cessation
- corticosteroids
- chemotherapy agents
- lung transplant
41
what is Pulmonary lymphangioleiomyomatosis
rare disorder of premenopausal women
42
wha does Pulmonary lymphangioleiomyomatosis cause
hamartomatous smooth muscle infiltration of lungs
43
treatment of Pulmonary lymphangioleiomyomatosis
- lung transplantation
44
what is a granuloma
mass or nodule composed of chronically inflamed tissue formed by the response of the mononuclear phagocyte
45
what is granuloma characterised by
presence of epithelioid multinucleate giant cells
46
why does granuloma formation occur
to confine a pathogen and limit the extent of surrounding inflammation
47
where are granulomas seen
- TB
- fungal infections
- sarcoidosis
- hypersensitivity pneumonitis
48
what is sarcoidosis
multisystem granulomatous disorder
49
who does sarcoidosis affect
young adults
50
wha does sarcoidosis present with
- bilateral hilar lymphadenopathy
- pulmonary infiltration
- skin or eye lesions
51
what other infection can mimic sarcoidosis
beryllium posoning
52
how is sarcoidosis detected
CXR
53
who is most likely to contract sarcoidosis
Afro-Caribbean
54
what is Mantoux test results in sarcoidosis
negative
55
where can sarcoidosis affect
any organ
56
symptoms of sarcoidosis
- eye, skin or lymph nodes involved
- fatigue
- bilateral hilar lymphadenopathy
- erythema nodosum
- arthralgia
- fever
- wheeze
- SOB
- cough
- hepatomegaly
57
HRCT in sarcoidosis
non-caseating granulomas
58
what is bilateral hilar lymphadenopathy associated with
- dull ache in chest
- malaise
- mild fever
59
what is most common cause of erythema nodosum
sarcoidosis
60
what is initial test for sarcoidosis
chest x-ray
61
what does transbronchial biopsy show in sarcoidosis
- non-caseating granulomas
62
first line treatment for sarcoidosis
prednisolone
4-6 weeks
63
what is 2nd line treatment for sarcoidosis
immunosuppressant
e.g. methotrexate, azathioprine
(can be added to prednisolone)
64
what is end stage treatment for sarcoidosis
lung transplantation
65
who does Granulomatosis with polyangiitis affect
older adults
66
what is c-ANCA result in Granulomatosis with polyangiitis
positive with elevated PR3 antibodies
67
symptoms of Granulomatosis with polyangiitis
- bloody nasal discharge
- crusting and destruction
- sinusitis
- cough
- dyspnoea
- pleuritic chest pain
68
how should diagnosis be confirmed in Granulomatosis with polyangiitis
biopsy
69
another name for Anti-glomerular basement membrane disease
Goodpasture syndrome
70
what is goodpasture syndrome characterised by
- pulmonary haemorrhage
- glomerulonephritis
- presence of circulating antibodies
71
treatment of Goodpasture syndrome
plasmapheresis
prevents further antibody production
72
what is caplan syndrome due to
occupational dust inhalation
73
who gets caplan syndrome
coal workers pneumoconiosis
74
haven't done pulmonary infiltration with eosinophilia
haven't done pulmonary infiltration with eosinophilia
