Term
| What are the most common chronic diffuse infiltrative lung diseases? |
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Definition
Postinflammatory pulmonary fibrosis
Idiopathic pulmonary fibrosis |
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Term
| What are the steps of chronic diffuse infiltrative lung diseases? |
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Definition
-Initiation of tissue injury
-Maintenance of inflammation
-Resolution or development of fibrosis |
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Term
| Name the common symptoms of chronic diffuse infiltrative lung diseases. |
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Definition
-dyspnea of gradual onset
-nonproductive cough |
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Term
| What diagnostic imaging study would you use to dx chronic diffuse infiltrative lung diseases |
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Definition
|
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Term
| What drugs can cause chronic diffuse infiltrative lung diseases? |
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Definition
-Bleomycin
-cyclophosphamide
-Methotrexate
-Nitrosoureas |
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Term
| What noncytotoxic drugs can induce chronic diffuse infiltrative lung diseases? |
|
Definition
-Nitrofurantoin
-Amiodorone
-Gold
-Penicillamine
-Illicit drugs |
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Term
| Findings on CXR for chronic diffuse infiltrative lung diseases? |
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Definition
| B/L symmetrical interstitial infiltrates |
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Term
|
Definition
-One of the most common causes of drug induced lung disease
-cough, dyspnea, and fever
-Pleural effusion
-Eosiophilia
-Pleurisy |
|
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Term
|
Definition
-cough, dyspnea, fever
-pleural effusion
-Pulmonary toxicity 5-7% of cases |
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Term
|
Definition
| -Difficult to differentiate between drug or underlying cause |
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Term
|
Definition
-Talc-induced granulatosis
-pulmonary fibrosis
-Dx by biopsy |
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Term
| What are the types of pneumoconioses? |
|
Definition
-Asbestosis
-Silicosis
-Coal worker's pneumoconiosis
-Berylliosis |
|
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Term
| What are the main features of asbestosis? |
|
Definition
-pleural plaques
-Incr. malignancy
-Diffuse interstitial fibrosis |
|
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Term
| What are the sxs of asbestosis? |
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Definition
-Sxs
-Dyspnea onset after 15-20 yrs.
-non-productive cough
-rales
-clubbing
-cor pulmonale |
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Term
| Name the occupations that are at risk of developing silicosis. |
|
Definition
-mining
-cutting, polishing, and carving of stone
-foundry work
-sandblasting |
|
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Term
| With what disease does TB occur more frequently? |
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Definition
|
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Term
| What are the two forms of silicosis? |
|
Definition
-Simple nodular silicosis
-progressive massive fibrosis (PMF) |
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Term
| Name the findings that are seen on a CXR for silicosis. |
|
Definition
-opacities in the upper lobes
-hilar node enlargement w/ egg-shell calcifications |
|
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Term
| What pneumocomiosis disease is similar to sarcoidosis? |
|
Definition
|
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Term
| Name the differentiating sxs of berylliosis. |
|
Definition
-chest pain
-fatigue
-weight loss
-arthralgia |
|
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Term
| How would a person's labs turn out if they had berylliosis? |
|
Definition
-hyperuricemia
-hypercalcemia
-hypercalcinuria |
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Term
| What kind of diffuse lung disease is Farmer's lung? |
|
Definition
| Hypersensitivity pneumonitis |
|
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Term
| What are some of the features of Farmer's lung? |
|
Definition
-2/3 have granulomas
-development of fibrosis if chronic
-50% have bronchiolitis obliterans |
|
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Term
| List the sxs of acute hypersensitivity pneumonitis. |
|
Definition
| fever, chills, cough, dyspnea, and malaise 4-8 hrs after exposure. |
|
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Term
| How would you dx hypersensitivity pneumonitis? |
|
Definition
| Bronchoscopy with BAL and transbronchial biopsy. |
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Term
| Malignant diffuse infiltrative lung disease occurs with what diseases? |
|
Definition
-lymphangitic carcinomatosis
-alveolar cell carcinoma
-lymphoma
-leukemia |
|
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Term
| What are the findings of CXR in malignant diffuse infiltrative lung disease? |
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Definition
| B/L reticular/reticulonodular infiltrates, Kerley B lines, pleural effusion, and hilar lymphadenopathy. |
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Term
| Name the 11 chronic diffuse infiltrative lung diseases of unknown etiology. |
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Definition
| Sarcoidosis, idiopathic pulmonary fibrosis, desquamative interstitial pneumonia, acute interstitial pneumonia, lymphocytic interstitial pneumonia, bronchiolitis obliterans organizing pneumonia (BOOP), collagen vascular diseases, eosinophilic granuloma of the lung, alveolar, poteinosis, eosinophilic pneumonia, and diffuse alveolar hemorrhage. |
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|
Term
|
Definition
-Multisystem
-Noncaseating granulomas
-blacks 10x more than whites
-5% have normal CXR |
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Term
| List the sxs of sarcoidosis. |
|
Definition
-dyspnea
-cough
-fever
-B/L hilar lymphadenopathy
-arthralgia
-erythema nodosum |
|
|
Term
| What is the more common form of sarcoidosis? Rare? |
|
Definition
-Intrathoracic
-Extrathoracic |
|
|
Term
| What are some of the body systems affected by extrathoracic sarcoidosis? |
|
Definition
-skin (erythema nodosum and lupus pernio)
-eyes (uveitis)
-nervous system
-Cardiac
-endocrine |
|
|
Term
| Lymphocytic interstitial pneumonia |
|
Definition
-occurs with autoimmune diseases
-women
-rales and lymphadenopathy
-BAL = b cells |
|
|
Term
| What does BOOP stand for? |
|
Definition
| bronchiolitis obliterans organizing pneumonia |
|
|
Term
|
Definition
-secondary disease
-fever, malaise, fatigue, cough and dyspnea
-rales
-diagnose with CT/biopsy
-diff. dx=farmer's lung (no granulomas) |
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Term
| Name the collagen vascular diseases with associated pulmonary involvement. |
|
Definition
-SLE
-RA
-Polymyositis
-Dermatomyositis
-Sjogren syndrome |
|
|
Term
| What are some of the results of a PFT in collagen vascular diseases? |
|
Definition
-small airway obstruction
-decr. dlco
-hypoxemia at rest |
|
|
Term
| Eosinophilic granuloma of the lung. |
|
Definition
-Strong association with smoking
-Granulomas of the bone
-Pos. CT for cysts
-tx: smoking cessation |
|
|
Term
| Idiopathic pulmonary fibrosis |
|
Definition
-rales
-cyanosis
-cor pulmonale
-clubbing
-Dx: Exclusion
-lung transplant
-incr. risk of lung carcinoma |
|
|
Term
| Desquamative interstitial pnuemonia |
|
Definition
-clubbing
-men
-smokers
-CXR: vague bibasilar opacities |
|
|
Term
| Acute interstitial pnuemonia |
|
Definition
-progression in 30 days: dyspnea, cough with mucoid sputum to respiratory failure
-mortality 33-78% in 6 months |
|
|
Term
| what are the diseases that are assoc. with diffuse alveolar hemorrhage? |
|
Definition
-Goodpasture Syndrome
-glomerulonephritis
-vasculitits-Wegener's
-antiphospholipid Ab syn.
-Anticoagulants
-idiopathic pulmonary hemosiderosis (hemoptysis) |
|
|
Term
| What tests would you perform to dx diffuse alveolar hemorrhage? |
|
Definition
-Labs: anti-GBM Ab, antinuclear and anti-DNA, ANCA, complement levels, and immune complexes
-BAL: w/ iron stain, finding of hemosiderin-laden macrophages |
|
|
Term
|
Definition
-young smokers
-hemoptysis
-Fe anemia
-Renal failure
-fluffy perihilar acinar shadows
-PFT: restrictive, incr. Dclo
-Dx by presence of anti-GBM Ab |
|
|
Term
|
Definition
-Intra-alveolar accumulation of lipoproteinaceous material
-90% acquired caused by autoantibodies to GM-CSF
-3 presentations: Asymptomatic w/ abn. CXR, abrupt onset of dyspnea, cough, fever and chest pain, and gradual onset of dyspnea and cough.
-Dx: BAL findings of PAS positive material |
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Term
| What are the 7 forms of eosinophilic pneumonia? |
|
Definition
-Simple pulmonary eosinophilia (loffler syn.)
-Prolonged pulmonay eosinophilia w/o asthma
-Pulmonary eosinophilia with asthma
-Tropical pulmonary eosinophilia
-Pulmonary vasulitis
-Hypereosinophilic syn.
-acute eosinophilic pneumonia |
|
|
Term
| simple pulmonary eosinophilia |
|
Definition
-Transient, migratory infiltrates
-accumulation of eosinophils, macrophages and fluid
-tx: stop drugs causing, treat parasitic infection |
|
|
Term
| Prolonged pulmonary eosinophilia w/o asthma |
|
Definition
-middle-aged women
-productive cough, dyspnea, malaise, weight loss, night sweats, and fever
-Dx: CXR, BAL, peripheral eosinophilia and bronchoscopy |
|
|
Term
| Tropical pulmonary eosinophilia |
|
Definition
-asthma, fever, marked blood eosinophilia, and CXR with reticulonodular infiltrates
-recently traveled to Far East |
|
|
Term
|
Definition
-granulomatous inflammation of the lungs
-eosinophilia with elevated IgE levels |
|
|
Term
| Acute eosinophilic pneumonia |
|
Definition
| -cough, dyspnea, fever, tachypnea, and rales |
|
|
Term
|
Definition
-young women
-CT: cysts throughout lung |
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