Flashcards in interstitial and occupational lung disease Deck (14)
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?
- 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
- uveitis, parotitis
- most common, will go away on its own
what is chronic sarcoidosis?
- lung infiltrates (alveolitis)
- skin infiltrations
- peripheral lymphadenopathy
- 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