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;
42 Cards in this Set
- Front
- Back
|
hypersensitivity pneumonitis
etiol |
immune mediated granulomatous reaction to organic antigens
|
|
|
hypersensitivity pneumonitis
occupations/causes |
moldy hay/actinomycetes/farmers lung
pet birds/bird fanciers grain dust isocyanates AC systems |
|
|
organic dusts that cause ILD
|
byssinosis
inhalation of cotton, flax or hemp dust |
|
|
asbestosis exposure
|
bilat mid thoracic pleural plaques
malig mesothelioma (80% related to asbestos exposure) |
|
|
asbestosis
path, what part of lung TOB assoc? |
parenchymal fibrosis, in BASES
with >10 yrs mod exposure, but latency may be 30 yrs smoking/synergy |
|
|
asbestosis assoc w what type of lung cancers
|
squamous and adeno
|
|
|
Silica
assoc w what occupations |
most prevalent occ dx in world
mining, glassmaking, ceramics, sandblasting |
|
|
Silica cxr
|
fibrocalcific, upper lobes
hilar eggshell calcification increase susceptible to TB get yearly PPDs no tx but if worsening ck PPD |
|
|
Silicaproteinosis
|
big nodules from overwhelming exposure
alveolar filling w eosinophilic material present looking like pul edema |
|
|
Coal Workers pneumoconiosis
|
upper lung nodules
simple CWP worsens w exposure complicated CWP does not |
|
|
Caplans syndrome
|
seropos RA assoc w massive CWP
see periph lung nodules |
|
|
complicated CWP
|
progressive massive fibrosis w nodules >2 cm
TOB accelerates |
|
|
Berylliosis what is it, where from
|
cell mediated immune response
>2 yr exposure to even sm amts beryllium |
|
|
Beryllium cxr,
diagnose tx |
chronic interst pneum upperlob
+ hilar adenopathy--like sarcoid lymphocyte transformation test tx: steroids |
|
|
Idiopathic Interstitial Pneumonias (ILPs)
name 2 |
Idiopathic Pulmonary Fibrosis
Cryptogenic Organizing Pneumonia |
|
|
Idiopathic Pulmonary Fibrosis
etiol path |
prob autoimmune M=f 55 yo
leakiness of cap/alveolar wall causes wall damage--hyalinizes the alveolar memb |
|
|
IPF cxr
|
HRCT shows ground glass appearance
diagnosis of exclusion |
|
|
IPF course
|
early inflamm,
late fibrotic--restrictive dx, pul htn cor pulmonale progresses to death |
|
|
IPF PE
|
presents w dyspnea cough diffuse infil on cxr
clubbing no other s/s no drugs/infection/chemicals MUST R/O INFECTION/CANCER |
|
|
IPF pfts
|
restrictive/intrathoracic pattern
|
|
|
IPF tx
|
steroids +/- cyclphosphamides or azathioprine
best test for improvment is meas lung fxn/pfts, A-a gradient |
|
|
cryptogenic organizing pneumonia or COP or BOOP
etiol, path |
unknown etiol
bronchiolitis and chronic alveolitis prolif of granulocytes around airways |
|
|
COP
onset, presentation tx |
insidious onset wks-2 mos
fever, cough malaise, myalgias responds well to steroids |
|
|
Sarcoidosis
what is it path usu cxr |
multisystem
noncaseating granuloma usu bilat hilar/mediastinal LN |
|
|
Sarcoid
use of ACE |
no use in diagnosis
but can use to follow dx |
|
|
Sarcoid abnl labs
|
hypercalcemia hypercalciuria, hypergammaglobulinemia
|
|
|
Sarcoid diagnosis
|
of exclusion
+BAL inc lymphs helper/suppressor 4/1 culture, examine for orgs bronch bx noncaseating granuloma |
|
|
Sarcoid
what skin lesion shows good prognosis |
e nodosum
|
|
|
Sarcoid tx
|
75% resolve w/o tx
rare progression to pul fibrosis or htn severe:steroids, but not proven to induce remissions, but does help w sx. also plaqenil, remicade, mtx, thalidomide |
|
|
Eosinophilic Granuloma\
other names |
langerhans cell granulomatosis
Histiocytosis X |
|
|
Eosinophilic Granuloma
associations: physical findings |
pneumothorax, TOB
M>F lytic bone lesions diabetes insipidus (post pituitary involved) |
|
|
Eosinophilic Granuloma
CXR tx |
"honey comb" appearance
upper lungs STOP TOB |
|
|
Hand-Schuller-christian syn
|
lytic bone lesions
diabetes insidus exophthalmus Eosinophilic Granuloma |
|
|
Lymphangioleiomyomatosis
who gets it genetic relat to which dx |
premenopausal women
tuberous sclerosis |
|
|
Lymphangioleiomyomatosis
path |
immature sm musc proliferation in lymph, vasc and alveolar wall/peribronchial structures
get constrictions/cysts in these areas |
|
|
Lymphangioleiomyomatosis
cxr |
honeycombing diffusely thruout the lung
(upper lung only in eos granuloma) may see PTX |
|
|
Lymphangioleiomyomatosis
on effusion tap see |
chylous effusion
|
|
|
Lymphangioleiomyomatosis
tx |
stop all exogenous estrogens
lung transplant, but may recur in transplant |
|
|
Rheumatoid arthritis/ILD
|
see this in 1/3 of RA pts
pleurisy MC low glucose in pl fluid necrobiotic nodules upper lung |
|
|
SLE/ILD
|
pleuritis +/- effusion
diaphragm weakness hemoptysis |
|
|
Scleroderma/ILD
what 3 chgs do you see pulmonary here? |
1. interstitial fibrosis
2. intimal proliferation (AFFECTS BOTH LUNG/PLEURA!) 3. Potential aspiration/achalasia intimal prolif--pul htn out of proportion prone to pneumonia |
|
|
causes of pneumothorax
|
secondary: CF, eos granuloma(histiocytosis X=smoking males), LAM (premenopausal women)
ventilator related |
