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Interstitial Lung Disease Notes

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This is an extract of our Interstitial Lung Disease document, which we sell as part of our Respiratory Notes collection written by the top tier of University Of Leicester students.

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Interstitial Lung Disease
= Group of conditions causing diffuse parenchymal lung disease characterized by chronic inflammation +/- progressive interstitial fibrosis Common clinical features
- Extertional dyspnea
- Non-productive cough
- Abnormal breath sounds
- Abnormal CXR/HRCT
- Restrictive pattern on spirometry o Reduced FEV and reduced FVC (therefore ratio >80% = normal ratio) Classification
- Those with known aetiology e.g o Occupational/environmental e.g asbestosis, silicosis o Drugs e.g amiodarone, nitrofurantoin, sulfasalazine o Hypersensitivity e.g extrinsic allergic alveolitis o Infections e.g TB, fungi, viral
- Those with associated systemic disorders o Sarcoidosis o RA o SLE, systemic sclerosis, sjogren's syndrome o UC, autoimmune, thyroid disease
- Idiopathic o Idiopathic pulmonary fibrosis/cryptogenic fibrosing alveolitis o Cryptogenic organizing pneumonia o Lymphocytic interstitial pneumonia

Extrinsic Allergic Alveolitis A condition caused by hypersensitivity to inhaled organic dusts (e.g fungal spores, avian proteins) leading to an inflammatory reaction in distal airspaces Aetiology
- Inhalation of various antigens may result in a pulmonary inflammatory response
- E.g o Farmers Lung = mouldy hay (thermophilic actinomycetes) o Pigeon Fanciers Lung (pigeon, budgie, poultry (bloom)) o Woodworker's Lung (Wood, dust) Pathophysiology Inhalation of allergens Hypersensitivity reaction Acute phase exposure


Alveoli infiltrated with acute inflamm. Cells

Granuloma formation Obliterative bronchiolitis Fibrosis

Acute allergic alveolitis
- 4-8 hrs after exposure to high doses of antigen
- Systemic features = fever, malaise, headache
- Cough, breathlessness
- Inspiratory crackles, wheeze + cyanosis Chronic allergic alveolitis
- Prolonged low level antigen exposure causes features
- Progressive exertional breathlessness
- May be hx of acute episodes
- Weight loss
- Fine end insp. Crackles, cyanosis
- +/- Type 1 respiratory failure cor-pulmonale Investigation Bloods
- WCC, ESR Imaging
- CT scan

Acute Raised

Chronic May be normal

Multiple nodules Low lung volume, reticulo-nodular shadows

Fibrosis Fibrosis Type 1 resp. failure

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