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;
34 Cards in this Set
- Front
- Back
Order of pathogenesis of diffuse ILD.
|
injury -> alveolitis -> cellular and ct response -> repair or fibrosis
|
|
Six agents of injury that can lead to diffuse ILD.
|
1. ROS
2. serine proteases 3. cationic proteins 4. immune mechanisms 5. drugs 6. arachadonic acid metabolites |
|
A predominate Th2 type response, AKA humoral response, leads to _____.
|
fibrosis
|
|
A predominate Th1 type response, AKA cellular response, leads to _____.
|
healing
|
|
Lebow's Classification System consisted of two broad categories:
|
1. Acute Interstitial Pneumonias - Diffuse Alveolar Damage
2. Chronic Interstitial Pneumonias - UIP, DIP, LIP, GIP |
|
The key to identifying UIP histologically?
|
spatial and temporal heterogeneity
|
|
Areas just underneath epithelial surface w/ fibroblastic proliferation, characteristic of UIP
|
fibroblastic foci
|
|
DIP is characterized by?
|
accumulations of macrophages w/in alveolar space
|
|
RBILD is only seen in?
|
smokers, relatively mild respods well to smoking cessation
|
|
Rapid course over typically a few weeks from onset to death.
|
AIP
|
|
The key difference in UIP vs. NSIP.
|
temporal appearance: UIP is variegated (varied across section of lung) while NSIP has more uniform appearance (mostly inflammatory, or mostly fibrotic)
|
|
____ is prominent in NSIP compared to UIP.
|
Interstitial inflammation
|
|
Honeycombing most frequently seen in ____
|
UIP
|
|
T/F: Occasionally you'll see organizing pneumonia in UIP but never in NSIP.
|
False. Other way around.
|
|
Hyaline membranes are occasionally seen in ____.
|
AIP
|
|
Most common symptoms of ILD?
|
dyspnea and cough (nonproductive)
|
|
Most important early sign in ILD?
|
tachypnea
|
|
Physical exam findings in ILD?
|
digital clubbing, crackles or rails when listening to chest (Velcro)
|
|
Velcro sounds in ILD heard during?
|
mid-inspiration, compared to late inspiration heard w/ pulmonary edema
|
|
Better prognosis: UIP or NSIP?
|
NSIP
|
|
UIP responds well/poorly to steroids?
|
poorly
|
|
DIP and NSIP respond well/poorly to steroids?
|
well
|
|
Three physiologic characteristics of restrictive lung disease:
|
reduced lung volumes, reduced compliance, diffusion impairment
|
|
People with ILD, what typically drops w/ excercise?
|
O2 saturation
|
|
Typically all lung volumes are _____ ______ in ILD.
|
reduced proportionally
|
|
On high resolution CT, abnormalities in ILD are more clustered and severe where?
|
on the peripheral aspects of the lung
|
|
Radiographic honeycombing is a sign of the ______ of ILD.
|
end stages
|
|
Two main clinical classifications of ILD:
|
Known and Unknown etioligies
|
|
Name some of the known etiologies of ILD:
|
silica, gases/fumes, pigeon droppings, drugs, radiation
|
|
Most cases of ILD are of ____ etiology.
|
unknown
|
|
Causes of unknown etiology ILD.
|
UIP, collagen vascular disease like lupus, eosinophilic pneumonias and Wegener's granulomatosis
|
|
Possible therapy for ILD?
|
antiinflammatories (steroids?), azothioprine, colchicine (adjunct), N-acetyl cysteine
|
|
Last ditch effort for patients w/ ILD?
|
lung transplant
|
|
Prognosis of UIP
|
50% mortality in 5 years
|