Term
What is Brochoalveolar Lavage (BAL)? |
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Definition
Performed during fiberoptic bronchoscopy, samples cells from distant airways, check cell count, cytology & culture (mycobacterial, fugal, viral), required to diagnose interstitial lung disease involving hemoptysis and acute onset ILD |
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Term
What is the initial presentation of interstitial lung disease? |
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Definition
Progressive yspnea, nonproductive cough, crackles, clubbing of digits |
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Term
What mechanisms are responsible for illness in interstitial lung disease? |
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Definition
Injury, inflammation, and scarring |
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Term
What is the process of tissue injury in the interstitium? |
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Definition
Attempted tissue repair -> lost alveolar surface area, fibrosis -> eventual alveolar collapse |
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Term
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Definition
Inflammatory granulomatous disease, more prominent in women and african americans, can affect any organ, associated with erythema nodosum and hypercalcemia |
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Term
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Definition
Etiology unknown, T helper lymphocytes overreact to an unknown toxin, drug or pathogen entering via respiratory tract. Causes reticular nodular pattern |
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Term
What are some symptoms of Sarcoidosis? |
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Definition
Fever, weight loss, malaise, fatigue, raise red rash on face, arms and buttocks, red watery eyes, arthritis |
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Term
How is Sarcoidosis diagnosed? |
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Definition
Biopsy discovering any granuloma site, blood test for ACE and calcium levels, CXR, pulmonary function test, bronchoscopy, mediastinoscopy |
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Term
What is the 1-2-3 sign that indicates Sarcoidosis? |
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Definition
Separation between nodes (hilar adenopathy) and heart in sarcoid on a CXR |
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Term
What is Lofgren syndrome? |
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Definition
Acute illness associated with Sarcoidosis including hilar adenopathy, fever, erythema nodosum and arthralgia |
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Term
Describe drug induced interstitial lung disease |
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Definition
Often reversible, blood eosinophilia, crackles, pleural rub, restrictive defect upon pulmonary function test |
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Term
What are some common drugs that cause interstitial lung disease? |
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Definition
Nitrofurantoin, methotrexate, amiodarone, bleomycin, aspirin, terbutaline, talc (IV drug use) |
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Term
Describe radiation induced interstitial lung disease |
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Definition
Looks similar to drug induced ILD but localized to injured site, occurs 2-6 weeks after treatment |
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Term
What are some important diseases associated with interstitial lung disease? |
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Definition
Rheum. Arthritis, systemic lupus erythematosis, systemic sclerosis, polymyositis, Sjogren's syndrome, ankylosing spondylitis (Only one which causes upper lung apical fibrosis) |
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Term
What is Pulmonary Vasculitis? |
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Definition
AKA Wegener's Granulomatosis, allergic granulomatosis with angiitis, may or may not give ILD pattern on imaging |
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Term
How does Pulmonary Vasculitis present in the lungs? |
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Definition
Patchy necrosis in arteries, veins, granulomatous inflammation, upper or lower resp. tract and kidneys, Fatigue, weight loss, fevers, cough, dyspnea, hemoptysis, chest pain, joint pains |
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Term
What lab findings indicate Pulmonary Vasculitis? |
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Definition
+ANCA antibodies, antibodies to proteinase 3 |
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Term
What is Loffler's syndrome? |
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Definition
Transient or migratory pulmonary infiltrates, blood eosinophilia, caused by Ascaris lumbricoides or other parasitic infections |
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Term
What is Bronchiolitis obliterans? |
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Definition
Intraluminal polypoid plug of granulation tissue in terminal and respiratory bronchioles, results in ILD and COPD appearance, seen in seen in infectious pneumonias, diffuse alveolar damage, aspiration, usual interstitial pneumonia |
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Term
How does Bronchiolitis obliterans manifest? |
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Definition
Chronic scarring process via progressive obliteration of small airways and resultant lung disease, causes air trapping and exhibits "ground glass" opacity |
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Term
What is Bronchiolitis obliterans organizing pneumonia (BOOP)? |
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Definition
Polypoid endobronchial connective tissue masses extends continuously into alveolar ducts and alveoli, |
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