Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
39 Cards in this Set
- Front
- Back
|
Define diffuse infiltrative lund disease
|
Non-infectious, non-malignant processes of lower respiratory tract
--> restrictive ventilatory impairment, diffuse interstitial infiltrates Progressive and fatal |
|
|
What % of DPLD pts are asymptomatic?
|
5%
|
|
|
Most common presentation of DPLD
|
DOE
Cough Abnormal CXR Physiological impairment |
|
|
What functional abnormalities are seen in DPLD?
|
Reduced TLC, VC, FEV1, RV
FEV1/FVC = normal Abnormal gas exchange |
|
|
What is the best way to dx DPLD using radiograph?
|
HR CAT scan is most sensitive way
|
|
|
What physical findings are most common in DPLD?
|
Crackles (common in IPF, rare in granulomatous dz)
Joint deformities Skin changes Clubbing Signs of cor pulmonale |
|
|
What are general features of sarcoidosis?
Etiology? Pathology? More common in? Dysfxn? |
Unknown etiology
non-caseating granulomas 10x more common in blacks Most common in 20-30 yo Organ dysfxn from presence of granulomas in tissue |
|
|
What is the common presentation of sarcoidosis?
|
12-35% asymptomatic
Cough, dyspnea Any pulmonary sx Constitutional sx Extrapulmonary involvement |
|
|
What are the most common findings of extrapulmonary sarcoidosis
|
CNS involvement
Hypercalcemia |
|
|
What is seen on CXR in sarcoidosis?
|
Bilateral hilar adenopathy (most common)
Diffuse reticular, reticulonodular, nodular Multiple large nodules Diffuse alveolar infiltrates Can be **normal** |
|
|
What is the dx for sarcoidosis based on?
|
Dx of exclusion
|
|
|
What is the prognosis for sarcoidosis?
|
1/3 resolve spontaneously
1/3 stay the same some have permanent loss of lung fxn (including severe fibrosis) Death (5%) |
|
|
Other than sarcoidosis, what are the other granulomatous diseases?
|
Hypersensitivity pneumonitis
Silicosis Chronic beryllium disease |
|
|
What are some sources that can cause hypersensitivity pneumonitis?
|
mammalian and avian protiesn
Thermophilic bacteria and fungi |
|
|
What are the different syndromes of acute hypersensitivity pneumonitis?
|
Acute form
Subacute form Chronic form |
|
|
What are the sx of acute hypersensitivity pneumonitis?
|
After intermittenet and intense exposure wth sx 4-8 hrs exposure
|
|
|
What are teh sx of subacute and chronic hypersensitivity pneumonitis
|
Continual low level exposures
Insidious onset of dyspnea and fatigue Chronic can have irreversible lung damage |
|
|
What does the acute hypersensitivity pneumonitis look like on CXR?
|
Diffuse Ground glass appearance or air-space consolidations
|
|
|
What does the subacute hypersensitivity pneumonitis look like on CXR?
|
Fine nodular or reticulonodular pattern
|
|
|
What does the chronic hypersensitivity pneumonitis look like on CXR?
|
Mostly reticular pattern
|
|
|
Where is the lung damage in hypersensitivity pneumonitis?
|
Upper 2/3 of lung
|
|
|
What can be used to treat pneumonitis?
|
Early dx and Ag avoidance are key
Corticosteroids for tx of acute disease |
|
|
What are the different forms of silicosis?
|
Simple and Complicated
|
|
|
What is simple silicosis?
|
Asymptomatic or chronic cough from exposure of silicon dioxide
|
|
|
Where is the abnormality in silicosis? What is seen on CXR in simple silicosis?
|
Upper zone
Small rounded opaacities <10mm diameter |
|
|
What disease increases TB risk significantly?
|
Silicosis
|
|
|
What is complicated silicosis?
|
Progressive massive fibrosis
Occurs when smaller opacities coalesce |
|
|
What sx are seen in complicated silocosis?
|
Minimal to severe dyspnea
|
|
|
What is seen on CXR in complicated silicosis?
|
Confluent nodules >10mm
|
|
|
What is the morphology of chronic beryllium disease? LOCATION!
|
Non-caseating granulomas in lung parenchyma and hilar nodes
|
|
|
What are examples of interstitial inflammation/fibrosis?
|
Bleomycin toxicity
Chronic radiation fibrosis/bronchiectasis Asbestosis Idiopathic interstitial pneumonia |
|
|
What things are risk factors for bleomycin toxicity?
|
Renal insufficiency
Dose received Age >70 Radiation to chest Supplemental O2 |
|
|
When are changes from chronic radiation seen?
|
4-6 monhts after therapy
|
|
|
When does fibrosis from radiation become stable?
|
9-12 months after
|
|
|
What is seen on physical exam in asbestosis?
|
Basal crackles
Clubbin (late stages) Lower lobe linear opacities Early fibrotic changes with HR CAT scan |
|
|
What are complications of asbestos exposure?
|
Pleural effusion (clear spont)
Malignant mesothelioma Lung CA increased risk |
|
|
What is idiopathic interstitial pneumonia?
|
Group of disease w/o identifiable cause --> diffuse parenchymal lund dz
|
|
|
How is IIP classified?
|
Histological patterns
|
|
|
What is mean age of onset of IIP?
|
30-50yo
|
