Revision: Lung Conditions Flashcards
what is sarcoidosis?
Multisystem granulomatous (type IV) disorder to an unknown antigen
non caseating
who is sarcoidosis seen in?
under 50
Afro-Caribbean
Females
less common in smokers
signs of sarcoidosis?
- Lymphadenopathy (swollen lymph nodes)
- Crackles on lung auscultation
- erythema nodosum (shins)
- bilateral hilar lymphadenopathy- enlarged lymph nodes in chest
- arthritis
- uveitis, parotitis
- fever
- hypercalcaemia
- raised serum ACE
erythema nodosum
sarcoidosis
sarcoidosis management?
acute- self-limiting/ NSAIDs/ oral steroids e.g. prednisolone if end organ damaged
chronic-
sarcoidosis management?
acute- self-limiting/ NSAIDs/ oral steroids e.g. prednisolone if end organ damaged
chronic- - Oral steroids if end organ damage e.g. lung, eyes, heart, brain (usually needed) e.g. prednisolone
- May need immunosuppression e.g. METHOTREXATE, azathioprine, anti-TNF therapy (1st to 3rd line)
most common ILD?
idiopathic pulmonary fibrosis
signs of idiopathic pulmonary fibrosis?
- Clubbing
- Cyanosis
- Bilateral fine INspiratory crackles
- bilateral infiltrates on CXR
- ground glass (early), honeycombing (late stage)
idiopathic pulmonary fibrosis LFTs?
restrictive pattern
reduced FV1/ FVC
normal/ raised DEV1/FVC ratio
ow gas transfer
idiopathic pulmonary fibrosis investigations?
HRCT
CXR
PFTs
Lung biopsy
idiopathic pulmonary fibrosis management?
- Antifibrotic drugs (nintedanib, pirfenidone) - slow progression
- Oxygen if hypoxic
- Lung transplant in young patients
which type of hypersensitivity id hypersensitivity pneumonitis?
type 3
(IgG)
what is an antigen for farmer’s lung?
thermophilic bacteria
avian proteins- bird fanciers
fungi - malt workers
which kind of wheeze is in hypersensitivity pneumonitis?
no wheeze
management of hypersensitivity pneumonitis?
antigen avoidance, oxygen, steroids (oral), antifibrotic therapy to slow progression - pirfenidone, nintendanib
