Resp 11 - Interstitial Lung Disease

Question 1

Define ‘interstitial space’ in the lungs:

Answer 1

Potential space between alveolar cells and the capillary basement membrane, only apparent during disease states, when it may contain fibrous tissue/cells/fluid.

Question 2

What are some common occupational causes of interstitial lung disease?

Answer 2

• Asbestos
• Silica
• Coal dust

Question 3

What are some common treatments causing interstitial lung disease?

Answer 3

• Radiation
• Chemotherapy
• Methotrexate
• Nitrofurantoin
• Amiodarone

Question 4

What is the name given to idiopathic interstitial lung disease?

Answer 4

Fibrosing alveolitis

Question 5

List some signs/symptoms of interstitial lung disease:

Answer 5

• Shortness of breath
• Dry cough
• Reduced exercise tolerance
• Tachypnoea
• Decreased bilateral chest movement
• Coarsecrackles
• Tachycardia

Question 6

What are the 2 common types of extrinsic allergic alveolitis?

Answer 6

Acute = ‘Farmers lung’
- exposure to antigen from T.actinomycetes, often in mouldy hay

Chronic = ‘Bird fanciers lung’
- long term exposure to antigens from pigeons/budgies

Question 7

What are the 2 types of interstitial lung disease caused by an overactive immune system?

Answer 7

1) Sarcoidosis

2) Extrinsic allergic alveolitis

Question 8

Define pleural space:

Answer 8

Potential space between the visceral and parietal pleura.

Allows movement of the lung and chest wall with breathing.

Question 9

What are the 4 types of pleural effusion?

Answer 9

1) Haemothorax - blood
2) Chylothorax - chyle
3) Empyema - pus
4) Simple effusion - serous

Question 10

What is chyle?

Answer 10

Milky fluid containing lymph and free fatty acids, from the lacteals of the small intestine

Question 11

Describe pleurisy:

Answer 11

• Severe, sharp, ‘knife-like’ pain
• Worse on inspiration and large movements (sneezing, coughing, laughing)
• Inflammation of pleura
• If involved diaphragmatic pleura = pain in shoulder on same side

Question 12

List some causes of pleurisy:

Answer 12

• Infection (commonly viral)
• Pulmonary embolism
• Cancer
• Chest surgery
• Lung disease ie Asbestosis
• Autoimmune disorders ie SLE, RA, IBD
• Drugs ie Procanamide, Isoniazid

Question 13

Define pneumothorax:

Answer 13

Build up of air/gas in pleural space

Question 14

What are the 4 types of pneumothorax?

Answer 14

1) Primary spontaneous
2) Secondary to lung disease
3) Iatrogenic/traumatic
4) Tension

Question 15

What may increase the risk of developing a spontaneous pneumothorax?

Answer 15

• Smoking

- Family history

Question 16

What are the signs/symptoms of a pneumothorax?

Answer 16

• Distress
• Sweating
• Tachycarida
• Hyper-resonance over collapsed area
• Decreased/absent breath sounds
• Pleuritic chest pain
• Dyspnoea

Question 17

What are the main side effects of a chest drain?

Answer 17

• Infection risk

- Painful (irritates nerves between ribs)

Question 18

Define tension pneumothorax:

Answer 18

Progressive buildup of air in pleural space, due to lung laceration allowing air to escape to pleura and not return o lung

Question 19

What are the signs of a tension pneumothorax?

Answer 19

• Tachycardia
• Hypotension
• Hypxoaemia
• Hyper-resonance + no breath sounds on affected side

Question 20

What is the treatment for a tension pneumothorax?

Answer 20

• Cannula into affected side (2nd intercostal space, mid-clavicular line)
• O2