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57 Cards in this Set
- Front
- Back
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Idiopathic pulmonary fibrosis is commonly seen in what age group?
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60s-70s
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Sarcoid, connective tissue diseases, vasculitis are commonly seen in which age group?
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middle aged people
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What is likely the respiratory disease?
- wt loss - night sweats |
chronic eosinophilic pneumonia
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What is this disease?
physical exam - tachypnea - crackles at both lung bases - finger clubbing - signs of right sided heart failure |
interstial lung disease
- finger clubbing is commonly seen in IPF |
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What is this disease?
- CXR: hilar/mediastinal adenopathy - high ACE level |
sarcoidosis
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What is this disease?
CXR - hilar/mediastinal adenopathy - egg shell calcification |
silicosis
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What is the likely disease?
CXR - pleural involvement |
- asbestosis
- connective tissue disease |
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What is the likely disease?
CXR - upper lobe involvement |
- silicosis
- chronic hypersensitivity pneumonitis - ankylosing spondylitis - berylliosis - histiocytosis |
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List some diseases that show mixed restrictive and obstructive pattern in pulmonary function test.
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- sarcoidosis
- lymphanioleiomymomatosis - hisotiocytosis |
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What is this disease?
Morphology - varying degrees of inflammation and fibrosis - patchy lung involvement - alveolar space gets replaced by collagen |
- interstital pneumonia
- UIP * not steriod responsive |
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What is this disease?
- homogenous in nature - presevation of alveolar pattern - macrophages in air spaces - steroid responsive |
DIP
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What is this disease?
- inflammation and fibrosis - macrophages in air spaces |
NIP (nonspecific interstitial pneumonia)
- features of both UIP and DIP |
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What is this disease?
- fulminant fatal form of interstitial pneumonitis Symptoms - dyspnea insidious onset - tachypnea, dry cough, clubbing, bibasilar crakles, signs of right heart failure CXR - diffuse reticular markings at bases CT - thickened interlobular septum - traction bronchiectasis - subpleural honycombing - ground glass opacities |
IPF
- restrictive pattern - low DLCO - patient with smoking history may show mixed pattern |
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What is this disease?
Morphology - varying degrees of inflammation and fibrosis - patchy lung involvement - alveolar space gets replaced by collagen - cysts present in subpleural regions - fibrosis present in end stage |
UIP
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Name some collagen vascular diseases that may cause interstitial lung disease.
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- SLE
- RA - progressive systemic sclerosis - polymyositis and dermatomyositis - mixed connective tissue disease - Sjogren's syndrome |
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List lung involvements of SLE.
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- pleurisy (+/- pleural effusion)
- diaphramatic dysfunction - acute lupus pneumonitis - diffuse alveolar hemorrhage - diffuse intersitial disease - pulmonary hypertension - pulmonary thromboembolism |
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What systems are involved in SLE?
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- epidermis
- vascular system - serous and synovial membranes |
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What is the cause of this pleural effusion?
- bilateral - exudative - LE cell in fluid - ANA > 1:160 - response to steroids |
SLE
- LE cell in fluid diagnostic |
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How is acute lupus pneumonitis different from pneumonia?
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not much!
- difficult to differentiate - respond rapidly to steroids |
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How to treat diffuse alveolar hemorrhage on SLE patients?
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steroids/immunosuppressive therapy
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Pathogenesis of pulmonary HTN in SLE patients.
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- secondary to interstital lung disease or
- primary due to fibroproliferative changes in pulmonary vessel |
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T/F Patients with lupus anticoagulant can have recurrent pulmonary embolism.
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T.
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Lung problems associated with RA.
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Must know
- pulmonary nodules (similar to subcutaneous nodules) - BOOP - pulmonary HTN Minor - pleurisy (+/- effusion) - interstitial lung disease |
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What is the caues this pleural effusion?
- exudative in nature - low glucose - high rheumatoid factor |
RA
- other differential need to excluded: malignancy,infection. |
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What is the most common lung manifestation of RA?
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pleural effusion
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What is this disease?
- pulmonary nodule in single or bilateral lung fields - upper lobes - histologically similar to subcutaneous nodules |
RA
- needs to be differentiated from malignancy |
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What is this disease?
- coal workers with RA - rheumatoid nodules can undergo cavitation. |
caplan's syndrome
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Etiology of sarcoid.
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Unknown
- affect respiratory tract first - many other organs affected afterwards (CV, occular, renal, CNS) |
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Sarcoid is more commonly seen in what population?
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younger population: 20-40 yrs
blacks more than caucasians female more than males |
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What is this disease?
- fever - wt loss, night sweat - dyspnea, cough, wheezing - cardiac arrhythmia, heart block - occular uveitis - CN7 palsy - skin lupus pernio, erythema nodosum - monoarthralgia, polyarthralgia |
Sarcoid
- lungs - CV - Eyes - CNS - skin - muscles |
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How is diagnosis of sarcoid made?
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- clinical presentation and CXR (bilateral hilar adenopathy, enlarged right sided paratracheal LN, interstital infiltrates)
- confirmed by lab studies and tissue histology |
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What is this disease?
CXR - symmetrically bilateral hilar adenopathy - enlarged paratracheal LN (right sided) - bilateral patchy infilatrates - fibrosis at end stage |
sarcoid
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What is this sarcoid stage?
- bilateral hilar adenopathy |
stage I
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What is this sarcoid stage?
- bilateral hilar adenopathy - diffuse parenchymal diseaes |
stage II
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What is this sarcoid stage?
- no bilateral hilar adenopathy - diffuse pulmonary infiltrate |
stage III
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What is this sarcoid stage?
- fibrosis |
stage IV
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What is this disease?
- uveitis - parotitis - facial nerve palsy |
Heerfordt's syndrome
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What is this disease?
- fever - erythema nodosum - polyarthritis - bilarteral hilar adenopathy |
Lofgren's syndrome
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A patient is recently diagnosed of sarcoid. CXR showed a cavity lesion in his right upper lobe. But his PPD test is negative. Does he have TB infection on top of sarcoid?
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hard to tell because during active sarcoid patients jave anergy to common fungal and tuberculin antigen.
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What is this disease?
Labs - high serum ACE levels - leukopenia - abnormal renal function |
sarcoid
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In what disease(s) is ACE elevated?
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- sarcoid
- silicosis - asbestos - gauchers - leprosy - coccidiodomycosis - miliary TB - IBD |
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What is this disease?
Bronchoscopy - cobblestone appearance of mucosa - non-caseating granuloma: epitheloid cells and giant cells, surrounded by lymphocytes and plasma cells - T-helper cells increased |
sarcoid
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How to treat pulmonary sarcoid?
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steroid
- when symptomatic - 20-30% lung volume reduction and DLCO |
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What is this disease?
CXR - upper lobe nodules with egg shell calcifications of hilar nodes |
silicosis
- inhalation of free crystalline silica dust - foundry worker, sandblaster, tunneling, pottery making |
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People with silicosis is more at risk for what diseases?
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- typical and atypical mycobacterial infection
- need annual PPD testing |
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What is this disease?
- pulmonary fibrosis - shipyard workers, pipefitters, welders, sheet metal workers, automotive repair |
asbestosis
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What is this disease?
- pleural thickening/plaques - pleural effusion - rounded atelectasis - mesothelioma - bronchogenic carcinoma |
asbestosis
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What is this disease?
- upper lobe nodule - <1cm in size |
simple CWP
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What is this disease?
- pulmonary nodules: > 1cm size - may have fibrosis |
complicated CWP
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What is the most common fungi found in hypersensitivity pneumonitis?
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actinomycetes
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What is this disease?
- dyspnea on exertion - fatigue, poor appetite - CT: ground glass opacities - biopsy: inflammatory cells, granuloma, fibrosis |
hypersensitivity pneumonitis
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How to treat hypersensitivity pneumonitis?
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- remove antigen source
- chronic course of steroids |
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What is this disease?
- dry cough - fever - dyspnea - CXR: fleeting infiltrate - peripheral blood: eosinophilia |
acute eosinophilic syndrome
- secondary to parasites, drugs (sulfa drugs) or idiopathic |
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What is the name of the parasite that can cause Loeffler's syndrome?
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Ascaris larvae
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What are some parasites that can cause eosinophilic pneumonia?
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- ascaris larvae (Loeffler's syndrome)
- toxocara canis - strongloloides - ancylostoma |
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What is this disease?
- chronic cough - night sweats - wt loss - CXR: infiltrates in lung periphery - no blood eosinophila |
chronic eosinophilic pneumonia
- commonly confused with TB |
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How to treat chronic eosinophilic pneumonia?
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steroids
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