idiopathic interstitial pneumonia, Sarcoidosis

What signs and symptoms does idiopathic interstitial pneumonia present with?
chronic dyspnea and cough
Fever and finger clubbing may occur
Bibasilar (at the base of the lung) fine inspiratory crackles are commonly heard in auscultation

what are the results of a pulmonary function test in a pt with idiopathic interstitial pneumonia?
Pulmonary function testing shows a restrictive pattern (Reduced TLC), similar to that seen in Idiopathic pulmonary fibrosis (IPF)
If you find this you should also search for known causes,
-Drugs
-Collagen-vascular disease
-Hypersensitivity pneumonitis

What will you find in a lung biopsy in a pt with idiopathic interstitial pneumonia?
Varying degrees of inflammatory and fibrotic abnormalities that do not demonstrate a clearly identifiable pattern seen in usual interstitial pneumonia (UIP).

What test would you order to diagnose idiopathic interstitial pneumonia?
-PFT
would find Restrictive pattern (Reduced TLC)
We don’t use FEV1/FVC to dx restrictive disease
-High Resolution CT

What would you find on a CT scan of a pt with idiopathic interstitial pneumonia?
diffuse, patchy fibrosis with pleural-based honeycombing on CT scan

What is the treatment for idiopathic interstitial pneumonia?
High dose steroids (0.5-1.0 mg/kg/day initially, then tapered) are usually given for at least 3 months

What is the main disease that Sarcoid is mistaken for?
TB

What do you need to diagnose a pt with sarcoidosis?
What do you need to diagnose a pt with sarcoidosis?
CXR and CT are only suggestive. You need a Endobronchial biopsy demonstrating noncaseating granulomas
Usually need a Pulmonary Doctor
Need cells to send to pathology for tissue biopsy:
NCG
Stains negative for fungus
Stains negative for mycobacteria
90% of patients have granulomatous inflammation of the lung

What causes sarcoidosis?
idiopathic
Probably genetic and environmental factors
Not malignant
Not autoimmune

What diseases are on the differential when diagnosing sarcoidosis?
Granulomatous Diseases:
Sarcoid
Tuberculosis
Berylliosis
Fungal infections
Lymphoma is also in the differential

What is a granuloma?
It is a distinct pattern of inflammation that can appear virtually anywhere in the body. Large numbers of macrophages aggregate into nodular clumps forming sheets of multi-nucleated giant cells that release inflammatory exudate. lots of chemical junk is released

What is the DOC in treatment of sarcoidosis?
Anti TNF drugs like Pentoxifylline and Infliximab

What are the signs and symptoms of Sarcoidosis?
95% of the time they look like a flu or a pneumonia

A pt presents with mostly clear lungs with some crackles and Exertional O2 saturation present, what do you suspect?
sarcoidosis

What is the most common treatment for sarcoidosis?
75% require only symptomatic treatment which consists of NSAIDS

What are some complications of sarcoidosis?
Chronic lung disease and fibrosis
Ocular
Neurological
Cardiac

Recognize interstitial lung disease on chest x-ray thickened interstitium linear, irregular no confluence Recognize alveolar disease on chest x-ray fluffy homgenous patter w/coalescence “filled appearance” WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY …

Cattle – Bronchopneumonia Differentials Mannheimia haemolytica Histophilus somni Pasteurella multocida Mycoplasma bovis Trueperella (Arcanobacterium) pyogenes Sheep & Goat – Bronchopneumonia Differentials Mannheimia haemolytica Histophilus somni Bibersteinia (Pasteurella) trehalosi Pasteurella multocida Trueperella (Arcanobacterium) pyogenes Mycoplasma species WE WILL WRITE A CUSTOM …

INTRODUCTION Interstitial lung diseases (ILD) comprise a large, heterogeneous group of diseases with varying degrees of inflammation and fibrosis that have certain common clinical (progressive dyspnea), radiographic (usually bilateral infiltrates), physiologic (restriction, impaired gas exchange), and pathologic (varying degrees of …

Pulmonary Infections Occur when normal Pulmonary Defense Mechanisms Fail: 1. Loss of Cough Reflex = Coma / Anesthesia / Post-Op 2. Injury to Muco-Ciliary Escalator = Smoking / Squamous Metaplasia 3. IgA Deficiency (genetic / immunocompromised) 4. Decreased Macrophage Function …

What does pneumonia generally look like on CXR? More opaque than surrounding lungs and its margins are fluffy and indistinct except where they come up to a pleural margin. It tends to be homogenous in density, contain air bronchograms and …

Pulmonary Infections: when there is an impairment of the normal PULMONARY DEFENSE MECHANISM 1. loss of cough reflex (coma, anesthesia..etc.) 2. injury to mucociliary apparatus (smoking) 3. deficiency of secretory IgA in bronchial mucus 4. decreased phagocytic/bactericidal function of alveolar …

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