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Flashcards in interstitial and occupational lung disease Deck (14)
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what is an interstitial disease?

- any disease process affecting lung interstitial ie alveoli, terminal bronchi
- it interfered with gas transfer
- restrictive lung pattern
- symptoms: breathlessness, dry cough


what are the classifications of interstitial lung disease?

- acute
- episodic
- chronic = part of systemic disease, exposure to agent eg drugs, dust, idiopathic


what is sarcoidosis?

- tye 4 hypersensitivity
- multi-system involvement = lungs, lymph nodes, joints, liver, skin, eyes
- non-caseating granuloma of unknown aetiology
- less common in smokers


what is acute sarcoidosis?

- erythema nodosum = painful lumps on shins
- bilateral hilar lymphadenopathy
- arthritis
- uveitis, parotitis
- fever
- most common, will go away on its own


what is chronic sarcoidosis?

- lung infiltrates (alveolitis)
- skin infiltrations
- peripheral lymphadenopathy
- hypercalcaemia
- other organs = renal, myocardial, neurological, hepatitis, splenomegaly


what are the differential diagnosis's or sarcoidosis?

TB, lymphoma, carcinoma, fungal infection


what investigations would you carry out for sarcoidosis?

- chest xray
- pulmonary funciton
- blood test


what is the treatment for acute sarcoidosis?

- self limiting condition = usually no treatment
- steroids if vital organ affected impaired lung function, heart, eyes, brain, kidneys)


what is the treatment for chronic sarcoidosis?

- oral steroids
- immunosuppressions (eg azathioprine, methotrexate, anti-TNF therapy)


what is extrinsic allergic alveolitis (hypersensitivity pneumonitis)?

- type 3 hypersensitivity reaction to antigen lymphocytic alveolitis
- aetiology: thermophilic actinomycetes (farmers lung, malt workers, mushroom workers


what is acute extrinsic allergic alveolitis 1?

symptoms = cough, breathless, fever, myalgia, pyrexia, crackles, hypoxia, widespread pulmonary infiltrates in CXR
symptoms occur over several hours after acute exposure
treatment = oxygen, steroid, and antigen avoidance


what is chronic extrinsic allergic alveolitis II?

- repeated low dose antigen exposure over years
symptoms: pregressive breathlessness, cough, crackles, pulmonary fibrosis i nCXR - most common in upper zones
- low FEV1 & FVE
diagnosis = history of exposure, precipitins
treatment = remove antigen exposure, oral steroids if breathless or low gas transfer


what is idiopathic pulmonary fibrosis?

- most common interstitial lung disease
- not an inflammatory disease
- common in smokers
- rheumatoid, SLE, systemic sclerosis, asbestos, amiodarone, busulphan


what is the presentation of idiopathic pulmonary fibrosis?

- progressive breathlessness over several years
- dry cough

OE - clubbings, bilateral fine inspiratory crackles

Ix = restrictive defect of PFT
CxR = bilateral infiltrates
CT scan = retriculnodular fibrosis shadowing, worse at lung bases and peripheries
lung biopsy = not necessary if CT scan is diagnostic