interstitial lung disease

Question 1

whats the interstitium of the lungs

Answer 1

The connective tissue space around the airways and vessels

and the space between the basement membranes of the alveolar walls

Question 2

diffuse interstitial lung disease causes

Answer 2

• Reduced Lung Compliance ➢Stiff Lungs
• Low FEV1 & Low FVC but FEV1/FVC normal ratio
• Reduced Gas Transfer(Tcoor Kco)➢Diffusion abnormality
• Ventilation/Perfusion Imbalance When small airways affected by pathology

Question 3

interstitial lung disease symptoms

Answer 3

• DYSPNOEA
• Shortness of Breath on exertion
• Shortness of Breath at rest
• DYSPNOEA
• Shortness of Breath on exertion
• Shortness of Breath at rest

later on:

• Respiratory Failure –Type 1
• Heart Failure

Question 4

acute response to interstitial damage

Answer 4

diffuse alveolar damage (DAD)

with:

➢Major trauma

➢Chemical injury / toxic inhalation

➢Circulatory shock

➢Drugs

➢Infection incl viruses

➢Auto(immune) disease

➢Radiation

Question 5

chronic response to diffuse interstitial disease

Answer 5

usual interstitial pneumonitis

granulomatous responses

others

Question 6

granulomatous responses include

Answer 6

Sarcoidosis

Hypersensitivity pneumonitis

Question 7

presentation of sarcoidosis

Answer 7

1. Young adult

• Acute arthralgia
• Erythema nodosum
• Bilateral hilar lymphadenopathy

2. Incidental abnormal CXR or CT scan -no symptoms
3. SOB, cough and abnormal CXR

Question 8

sarcoidosis treatment

Answer 8

corticosteroids

Question 9

diagnosis of sarcoidosis

Answer 9

• Clinical findings
• Imaging findings
• Serum Ca++ and ACE
• Biopsy

Question 10

antigens for hypersensitivity pneumonitis

Answer 10

•Thermophilic actinomycetes

• Micropolysporafaeni
• Thermoactinomycesvulgaris
• Bird / Animal proteins-faeces, bloom
• Fungi -Aspergillus spp
• Chemicals•

Others

Question 11

acute presentation of Hypersensitivity Pneumonitis

Answer 11

• Fever, dry cough, myalgia,
• Chills 4-9 hours after Ag exposure
• Crackles, tachyopnoea, wheeze
• Precipitating antibody

Question 12

chronic presentation of Hypersensitivity Pneumonitis

Answer 12

• Insidious
• Malaise, SOB, cough
• Low grade illness
• Crackles and some wheeze

Question 13

Hypersensitivity Pneumonitis hypersensitivity types

Answer 13

type 3- Softcentriacinarepithelioid granulomata

type 4- Interstitial pneumonitis

Question 14

what zone does Hypersensitivity Pneumonitis occur

Answer 14

upper

Question 15

causes of usual interstitial pneumonitis

Answer 15

drugs

asbestos

connective tissue diseases

viruses

mainly idiopathic

Question 16

UIP histophathology

Answer 16

• Patchy interstitial chronic inflammation
• Type II pneumocyte hyperplasia
• Smooth muscle and vascular proliferation
• Evidence of old and recent injury
• Proliferating Fibroblastic Foci

Question 17

UIP presentation

Answer 17

• elderly >50 M>F
• Pathology is Usual Interstitial Pneumonitis

Clinically show:

• Dyspnoea, Cough,
• Basal Crackles, Cyanosis, Clubbing

Question 18

chronic diffuse interstitial disease ultimately leads to

Answer 18

Fibrosis or End-Stage Honeycomb Lung

Question 19

what does Diffuse Interstitial Lung Disease ultimately lead to

Answer 19

Fibrosis or End-Stage Honeycomb Lung

Question 20

what are ILDS

Answer 20

> 200 diseases causing thickening of the interstitium and can result in pulmonary fibrosis