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Pulmonary Disease 4
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Question | Answer |
---|---|
The term interstitial lung disease refers to a? | broad group of inflammatory ling disorders |
What are some anatomic alterations of the lung associated with interstitial lung disease? | destruction of alveoli and pulmonary capillaries, Fibrotic thickening, granulomas, honeycombing, cavity formation, pleural plaques, bronchospasm, excessive secretions |
Other problems associated with interstitial lung disease? | increased WOB and RR, decreased compliance, decreased DLCO, decreased TLC. Normal ABG until substantial lung injury occurs, |
What is the most common medication given for interstitial lung disease? | corticosteriods |
Interstitial lung disease of a known cause can be caused by? | occupational, environmental, and therapeutic exposures |
What is pneumoconiosis? | a disease of the lungs due to inhalation of dust, characterized by inflammation, coughing, and fibrosis |
Inorganic particulate (dust) can cause? | Asbestosis, common form of interstitial lung disease |
Common sources with asbestos fibers? | insulation, fire fighting suits, cements, roofing material, brake lining, automobiles, floor tiles, mechanics |
The asbestosis fibers are inhaled, perforate the alveoli and enter the pleural cavity, this causes? | pleural calcification, this diagnosis asbestosis |
Large amounts of coal dust causes? | coal workers pnuemoconiosis ( black lung) |
Coal dust by itself is chemically inert, what causes the CWP? | the slicia found in the coal, silicone dioxide particles (causes silicosis) |
Inorganic materials exposure causes interstitial lung disease, this is also called pneumoconiosis. These causes are? | dust, asbestos, coal, silica, beryllium |
Organic material exposure can cause hypersensitivity pneumonitis, this eventually? | causes interstitial lung disease, it is a cell mediated response cause by inhalation of offending agents or antigens |
Hypersensitivity pneumonitis caused by mouldy hay? | farmers lung |
What are other hypersensitivity pneumonitis causes? | Byssinosis (cotton), Aspergillosis ( organism present everywhere, some people are allergic) Sick building syndrome... This has nothing to do with histoplasmosis! |
Common occupations associated with silica exposure? | sandblasting, tunneling, hard rock mining, stonecutting, caeramics, brick making |
Other causes of inorganic interstitial lung disease? | Siderosis (iron, welders), Talcosis ( talcs, ceramic workers) |
Interstitial lung disease can be generally caused by? | inorganic substance, organic substance, or systemic disease |
What are some systemic drugs that can present as interstitial lung disease? | rheumatoid arthritis, caplans syndrome, systemic lupus, sarcoidosis, collagen vascular disease |
Rheumatoid arthritis can present as not just joint pain? | an inflammatory join disease that can involve the lungs, can present as pleurisy with or without effusion (pleural effusion) |
Caplans syndrome can be caused by rheumatoid arthritis, it is? | ( aka rheumatoid pneumoconiosis) pulmonary fibrosis of the lung common in coal minors |
Collagen vascular disease is? | a common form of systematically caused ILD |
Systemic lupus has the highest incidence of or causing lung disease, the percentage? | Involvement of the lungs appears in 50%-70% of cases |
Lung changes associated with systemic lupus? | pleurisy with or without effusion, atelectasis, diffuse infiltrates, pneumonitits, diffuse ILD, pulm edema, diaphragm disfunction, infection |
Sarcoidosis is of unknown origin, it is characterized by? | tubercles, and non necrotizing epitheloid tissue (granuloma) |
What is the clinical hallmark of sarcoidosis? | an increase in the three major immunoglobulins ( IgM, IgG, and IgA) |
With sarcoidosis women are? | affected more often than men, more common in african americans |
Idiopathic ILD has an unknown cause, it is? | inflammatory and progressive with varying degrees of fibrosis. can be known at hammen-rick syndrome ( was discovered by him) |
Diagnosis of an idiopathic ILD is done by? | open lung biopsy, most diagnosed with this have a more progressive course and usually death occurs withing 4-10 years, difficult diagnosis |
Goodpastures syndrome is an ILD of unknown cause and origin, it involves? | two organ systems, the lungs and kidneys, in the lungs there are recurrent episodes of pulmonary hemorrhage and fibrosis |
Chest assessment finding for ILD? | honeycombing on xray, crackles or bronchial breath sounds, pleural friction rub |
The management of ILD is directed at? | the inflammation associated with the various disorders |
Cancer is a term that? | refers to abnormal new tissue growth, progressive uncontrolled multiplication of cells, the new growth is called a tumor |
Lung cancer is characterized by? | inflammation, swelling, and destruction of bronchial airways and alveoli, excessive mucous production, atelectasis, cavity formation |
The most common cause of cancer? | cigarette smoking, industrial asbestos is 2nd mist common |
Male smokers are 22 times more likely to develop lung cancer, females? | are 12 times more likely |
Small cell cancer (oat cell) ? | most aggressive and responds best to chemotherapy and radiation therapy, no surgery |
Small cell cancer accounts for 14% of lung cancers, it is associated with? | cigarette smoking , worst prognosis |
Non small cell is more common and accounts for? | 75-85% of all lung cancers, usually gets surgery then chemo or radiation |
What are the non small cell cancers? | squamous cell carcinoma, adenocarcinoma, large cell (undifferentiated) |
Squamous cell accounts for? | 30% of lung cancers |
Adenocarcinoma has what features? | glandular configuration and excess mucous production |
Adenocarcinoma is more common women and is not? | associated with smoking, it is the most common form of cancer is non smokers |
Large cell carcinoma accounts for? | 10-15% of lung cancers |
Cancer can present with pretty much any type of symptoms, some common ones are? | weight loss, pneumonia, hemoptysis, abnormal xray, weakness, bone pain/weakness, seizures, loss of appetite, neurological problems, enlarged lymph nodes |