Overview of Disease

Question 1

Asthma

Answer 1

eosinophillic, chronic inflammation of the large and small airways which is reversible

Question 2

COPD

Answer 2

result of smoking - obstructive disease neutrophillic

Question 3

Atopy

Answer 3

allergy

Question 4

Airway Remodelling

Answer 4

as a result of chronic inflammation in the airway

Question 5

Eosinophils

Answer 5

a white blood cell containing granules that are readily stained by eosin.

Question 6

Neutrophils

Answer 6

most abundant type of granulocytes

Question 7

Macrophages

Answer 7

a large phagocytic cell

Question 8

Diurnal variability

Answer 8

variations between morning and night

Question 9

Bronchodilator reversibility

Answer 9

The reversibility of the an airway disease by a bronchodilator

Question 10

Chronic Bronchitis

Answer 10

neutrophillic inflammation

Question 11

Emphysema

Answer 11

a form of COPD

Question 12

Cor Pulmonale

Answer 12

condition that most commonly arises out of complications from high blood pressure (pulmonary hypertension). It’s also known as right-sided heart failure

Question 13

ACOS

Answer 13

Asthma and COPD overlap syndrome - more responsive to to steroids

Question 14

DPLD

Answer 14

Diffuse Parenchymal Lung Disease

Question 15

What is the DPLD?

Answer 15

A restrictive thoracic disease - a disease of alveolar structures

Causes issues in gas exchange

There is fluid in the alveolar air spaces

CO2 not affected as ventilation is normal

Question 16

What is the primary abnormality in DPLD?

Answer 16

hypoxia –> impaired gas exhange

Question 17

What are the causes of DPLD?

Answer 17

Cardiac Pulmonary Oedema

Non-cardiac - i.e. sepsis or trauma causing leaking pulmonary capillaries

Question 18

Causes of DPLD (3)

Answer 18

Infective Disease

Infarction

Other disease such as Autoimmune Rheumatoid, BOOP

Question 19

Granulomatous Alveolitis

Answer 19

Collection of inflammatory cells

Extrinsic Allergic Alveolitis

Sarcoidosis

Question 20

Extrinsic Allergic Alveolitis

Answer 20

Hypersensitivity Penumonitis Type 3 reaction

Farmers Lung - mouldy hay, granulomatous

Avian - bird allergens

Question 21

Causes of drug induced alveolitis (4)

Answer 21

Amiodarone

Bleomycin

Methotrexate

Gold

Question 22

Toxic Gas Fumes which cause alveolitis

Answer 22

Chlorine

Question 23

Causes of fibrosing alveolitis

Answer 23

Rheumatoid

Cryptogenic

Question 24

Auto-immune causes of Alveolitis

Answer 24

Systemic Lupus Eryhtmitis

Wegners

Churg-Strauss

Bechet’s

Question 25

Another word for dust-disease

Answer 25

pneumoconiosis

Question 26

Fibrogenic dust-disease (alveolitis)

Answer 26

asbestosis

silicosis

Question 27

Non-fibrogenic dust disease (alveolitis)

Answer 27

Siderosis (Iron)

Stanosis (Tin)

Baritosis (Barium)

Question 28

Eosinophillic causes of DPLD

Answer 28

Drugs - nitrofurantoin

Fungal - aspergillis

Parasites - toxocara, ascaris, filaria

Autoimmune - churg strauss, polyarteritis

Question 29

Clinical Presentation of DPLD (6)

Answer 29

1. Breathless on exertion
2. Cough but no wheeze
3. Finger Clubbing
4. Inspiratory Lung Crackles
5. Central cyanosis
6. Pulmonary fibrosis occurs as end stage response to chronic inflammation

Question 30

DPLD Diagnosis from:

History

Lung Volumes

Gas Diffusion

Arterial Oxygen

Answer 30

History - pets, occupation, drugs, arthritis

Lung Volumes - FEV1 and FVC decreased - normal ratio

Peak Flow Normal

Reduced Gas Diffusion TLCO

Decreased PaO2 and SaO2 at rest or exercise

Question 31

1st Line Treatment of DPLD

Answer 31

Systemic corticosteroids

inhaled steroids are not effective

Question 32

2nd Line treatment of DPLD

Answer 32

oral Azahioprine

Anti-fibrotic agents - Pirfenidone, Nintedanib

Anti-oxidant agents - Acetylcysteine

Question 33

What is the last resort treatment for end stage DPLD?

Answer 33

Lung transplant

Question 34

This is _______ ________ caused by sarcoidosis

Answer 34

Erythema Nodosum

Question 35

What is shown here?

Answer 35

Bilateral hilar lymphadenopathy

Sarcoidosis