Question Answer
Does it show a restrictive or obstructive pattern? It can show as either or both.
During the chronic stage what characterizes the general inflammatory response? Infiltration of numerous white blood cells and some fibroblasts in the alveolar walls and interstitial spaces.
What are the pathologic changes associated with chronic interstitial lung disease? Fibrotic thickening of the respiratory bronchioles, alveolar ducts, and alveoli Granulomas Destruction of the alveoli and adjacent pulmonary capillaries Honeycombing and cavity formation Airway obstruction caused by inflammation and bronchial constriction
What is another name for extrinsic alveolitis? Hypersensitivity pneumonitis.
What is extrinsic allergic alveolitis? Immunologically mediated inflammation of the lungs caused by the inhalation of a variety of offending agents.
What is sarcoidosis? Multisystem granulomatous disease of unknown etiology.
What is/are the manifestations of the lung in sarcoidosis? Interstitial lung disease, enlargement of the mediastinal lymph nodes, or a combination of both.
How is sarcoidosis diagnosed? Usually based on the clinical presentation, followed by confirmation with a chest radiograph and histologic evidence obtained by biopsy.
What is another name for eosinophilic granuloma? Histiocystosis X
What characterizes eosinophilic granuloma? Numerous small interstitial granulomas scattered throughout the lungs.
Who are more prone to get eosinophilic granuloma? Smokers and ex-smokers between 20 and 40 years of age, and males more than females.
What is another name for pulmonary vasculitides? Granulomatoius vasculitides.
What is pulmonary vasculitides? Consists of a heterogeneous group of pulmonary disorders characterized by inflammation and destruction of the pulmonary vessels.
What characterizes Wegener’s granulomatosis? Necrotizing, granulomatous vasculitis focal and segmental glomerulonephritis Variable degree of systemic vasculitis of the small veins and arteries.
Wegner’s granulomatosis, Churg-Strauss syndrome, and lymphomatoid granulomatosis fall under what category? Pulmonary vasculitides.
What is idiopathic pulmonary fibrosis (IPF)? Progressive inflammatory disease with varying degrees of fibrosis.
What will be seen in a severe case of idiopathic pulmonary fibrosis (IPF)? honeycombing.
What is the etiology of idiopathic pulmonary fibrosis (IPF)? Unknown
What are the major entities of IPF? Desquamative interstitial pneumonia (DIP) and usual interstitial pneumonia (UIP).
What are the most prominent features of DIP? hyperplasia and desqumation of the alveolar type II cells.
What happens with the alveolar spaces? they get packed with macrophages, and there is an even distribution of the interstitial mononuclear infiltrate.
What are the most prominent features of UIP? Interstitial and alveolar thickening caused by chronic inflammatory cells and fibrosis.
What happens in severe cases of UIP? Fibrotic connective tissue replaces the alveolar walls, the alveolar architecture becomes distorted, and honeycombing develops.
Which has a better prognosis, DIP or UIP? DIP
What causes death in UIP and DIP? Progressive acute ventilatory failure, complicated y pulmonary infection.
What causes drug-induced interstitial lung disease? Chemotherapeutic or cytotoxic agents.
What is the etiology of drug-induced interstitial lung disease? Not known
How is drug-induced interstitial lung disease diagnosed? open lung biopsy
What is another name for collagen vascular disease? connective tissue disorder
What is a multisystem inflammatory disease that are immunologically mediated? collagen vascular disease
How does rheumatoid arthritis involve the lungs? 1)pleurisy with or without effusion2)interstitial pneumonitis3)necrobiotic nodules4)Caplan’s syndrome5)pulmonary hypertension secondary to pulmonary vasculitis
What is another name for Caplan’s syndrome? rheumatoid pneumoconiosis.
What is systemic lupus erythematosus? multi-system disorder that mainly involves the joints and skin.
What is/are the pulmonary manifestations of SLE? 1)pleurisy with or without effusion2)atelectasis3)diffuse infiltrates and pneumonitis4)diffuse interstitial lung disease5)uremic pulmonary edema6)diaphragmatic dysfunction7)infections
What is BOOP? connective tissue plugs in the small airways
What is associated with BOOP? connective tissue disease, toxic gas inhalation, and infection.
What are the clinical manifestations of chronic interstitial lung disease? increased alveolar-capillary membrane thickness and bronchospasms
What is/are the clinical data obtained with chronic interstitial lung disease? increased RR, HR, cardiac output and BP.
What are the chest assessment finding with chronic interstitial lung disease? increased tactile fremitus, dull percussion note, bronchial breath sounds, crackles, rhonchi, and wheezing,
What are the radiologic findings for chronic interstitial lung disease? bilateral infiltrates, granulomas, cavity formation, honey-combing, air bronchograms.