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;
40 Cards in this Set
- Front
- Back
|
inorganic particles that cause ILD
|
asbestos
silica smoking |
|
|
organic particles that cause ILD
|
moldy hay- goes away
moldy cheese pigeon droppign mummy |
|
|
drugs that cause ILD
|
amiodarone
|
|
|
CT disorders that can lead to ILD
|
RA and scleroderma
|
|
|
usual interstitial pneumonia UIP
|
seen in IPF, but also in RA scleroderma SjoS
|
|
|
broncholitis obliterans and organizing pneumonia
|
seen in COP RA PM/DM
|
|
|
what do you need to diagnose ILD? 3 things
|
clinical data
radiogrophs pathology |
|
|
History and PE
|
cough, SOB
drugs? chemo joint problems, rashes, thick skin distal clubbing velcro rales bilateral bottom of lungs |
|
|
PFT for ILD
|
restriction, low TLC
impaired DLCO normal O2 at rest |
|
|
what are ground glass opacities?
|
more inflamation mor cells, more white stuff
reversible acute intersitial pneumonia acut hypersensitve pneumonitis CTD-ILD |
|
|
what are reticular opacities?
|
lacy
some degree of scarring IPF NSIP, collagen vascular disease, CTD ILD |
|
|
what is honeycombing?
|
established fibrosis
dead lung, not reversible IPF.... CTD ILD, asbestosis chrnic hypersens Pneumonia |
|
|
Usual interstitial pneumonia
|
Worse prognosis of the histo patterns
temporal heterogenous pattern: normal old fibro new fibro IPF |
|
|
non specific interstitial pneumonia
|
temporally homogenous- diffuse inflmation, alveolar walls are thickened
better prognosis common in CTDs |
|
|
bronchiolitis obliterans with organizing pneumonia
|
excellent prognosis- treat w/steroids
patch plugs of granulation in alveoli healling pneumonia, infection, drug rxns |
|
|
granulomatous inflamation
|
histo patern with rim of lymphocytes aroudn multinucleated giant ells (foreign body or infection) patched or diffuse
variable prog sarcoid, hypsens pneumonitis, infections, MTB fungus |
|
|
what CTDs can cause ILDs?
|
RA SLE scleroderma PD/DM SjoS
mainly RA and scleroderma |
|
|
what histo patterns do you see in CTD ILDs?
|
RA- UIP is more prevalent, but also see NSIP
SS-NSIP NSIP most prevalent in general CTDs better prognosis than IPF |
|
|
RA with secondary ILD
|
worse the joints are the worse the lungs are usually RF and CCP are high with lung involve.
40% have ILD, more common in men immunosuppressive helps some CT- shows exensive scarr and honeycomb or ggo |
|
|
Systemic sclerosis
|
very deadly
immune complex attacks small vessels of skin, increase collagen deposits (smooth skin), pHTN, raynauds, esophageal dysmotility, kidney fil no lung transplant just like IPF |
|
|
what do you see in a radiograph of someone with asbestosis
|
pleural plaque, pleural thickening, fibrosis of lung, round atelectasis, honeycomb
|
|
|
what kind of cancer is associated with asbestos
|
mesothelioma
|
|
|
how do you manage asbestosis?
|
prevent exposure
smoking cessation early detection supplemtneal O2 prompt treatment of resp infect pneumocoocal and flu shots STEROIDS DONT WORK |
|
|
what is the most common ILD
|
IPF
|
|
|
how can you Dx IPF
|
HRCT
|
|
|
what are the top three causes of digital clubbing?
|
IPF, congenital HD (isenmengers) and CF
|
|
|
what type of histo pattern do you see in IPF?
|
UIP, honeycombing, no ggo
|
|
|
who gets IPF?
|
typically white men over 50
|
|
|
what is the median survival for someone Dx with IPF
|
about 3 years
|
|
|
do antiinflamatories help IPF
|
no! inflamation isnt prom in UIP.
Steroids don't help either, they hurt! IPF may be a disorder of healing process |
|
|
what is the pathophysiology of IPF
|
myofibroblasts never die and continue to prod. EDM that is not reabsorbed-->failiure of reepithelization of new lung tissue
|
|
|
what are the 5 take home points for IPF
|
1. most common ILD, worse prog
2. Disease of older caucasian 3. HRCT alone may Dx 4. secondary to disorderd wound healing 5. no effective Rx, consider LT ASAP |
|
|
what is sarcoidosis?
|
chronic multi organ granulomatous inflmatory disease
10x more in AA exclude histo and blasto |
|
|
what findings suggest sarcoidosis?
|
young AA
noncaseating granulomas no evidence of infection cel ratio of CD4:CD8 > 2:1 |
|
|
how do you treat sarcoidosis?
|
immunosupressives only if there are extrathoracic involvement
ibuprofen for discomfort |
|
|
what is lofgren's syndrom?
|
erythema nodosum in legs
hilar lymph node enlargement (lymphoma) ankle arthritis associated with sarcoidosis |
|
|
lupus pernio
|
pathognomonic for sarcoidosis
indolent red lesions on cheeks nose lips not painful poor prognosis |
|
|
erythema nodosum
|
classic for sarrcoid, good prognosis
painful red areas btwn knee and ankle treat with NSAIDS |
|
|
what is unique about calcium metabolism in sarcoidosis
|
hypercalcuria= a lot of kidney stones, cure by treating sarcoid
hypercalcemia less common that uria antingen activates alveolar macrophages--> increased production of 1a hydroxylase--> incr 1,25 Vit D (not normally made in lungs) and calcium |
|
|
is high serum ACE related to sarcoidosis
|
yes, but not useful clinically
|
