Diferencia entre revisiones de «Interstitial lung disease»
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* Restrictive lung disease | * Restrictive lung disease | ||
* Sarcoidosis | * Sarcoidosis | ||
* Silicosis | * Silicosis | ||
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==Evaluation== | ==Evaluation== | ||
Revisión del 12:59 31 oct 2017
Background
- General group of diseases that involve the lung parenchyma
- Grouped together because of similar clinical, physiologic, radiographic, or pathologic findings
- Specific diseases separated into ones with known causes and idiopathic
- Treatment and prognosis differs between specific diseases
- Examples of specific diseases: interstitial pneumonia, hypersensitivity pneumonitis, cryptogenic organizing pneumonia, acute interstitial pneumonitis, sarcoidosis, idiopathic pulmonary fibrosis
Clinical Features
- Symptoms: progressive exertional dyspnea, persistent nonproductive cough, hemoptysis, pleuritic chest pain
- History of occupational exposure: asbestosis, silicosis
- Abnormal chest imaging or pulmonary function tests
- Take detailed history making sure to focus on past medical history (connective tissue disease, inflammatory bowel disease, malignancy), smoking history, family history, medications, occupational and environmental exposures
- Physical exam is generally nonspecific
Differential Diagnosis
- Pneumonia
- Asbestosis
- Berylliosis
- Pulmonary edema
- Coal worker's pneumoconiosis
- Cryptogenic organizing pneumonia
- Drug induced pulmonary toxicity
- Farmer's lung
- Hypersensitivity pneumonitis
- Interstitial pulmonary fibrosis
- Collagen-vascular disease
- Lung malignancy
- Restrictive lung disease
- Sarcoidosis
- Silicosis
Acute dyspnea
Emergent
- Pulmonary
- Airway obstruction
- Anaphylaxis
- Angioedema
- Aspiration
- Asthma
- Cor pulmonale
- Inhalation exposure
- Noncardiogenic pulmonary edema
- Pneumonia
- Pneumocystis Pneumonia (PCP)
- Pulmonary embolism
- Pulmonary hypertension
- Tension pneumothorax
- Idiopathic pulmonary fibrosis acute exacerbation
- Cystic fibrosis exacerbation
- Cardiac
- Other Associated with Normal/↑ Respiratory Effort
- Other Associated with ↓ Respiratory Effort
Non-Emergent
- ALS
- Ascites
- Uncorrected ASD
- Congenital heart disease
- COPD exacerbation
- Fever
- Hyperventilation
- Interstitial lung disease
- Neoplasm
- Obesity
- Panic attack
- Pleural effusion
- Polymyositis
- Porphyria
- Pregnancy
- Rib fracture
- Spontaneous pneumothorax
- Thyroid Disease
- URI
Evaluation
Work up and test results differ between types of interstitial lung diseases. Below are common studies obtained to determine disease. See page for specific disease for specific labs/imaging and findings.
- CBC/CMP
- Serologic studies: ANA, Rheumatoid factor
- Imaging: Chest x-ray, chest CT
- Pulmonary function tests
- Cardiac ECHO
- Bronchoalveolar lavage
- Lung biopsy
Management
- Management differs between specific types of interstitial lung diseases. This is why it is important to determine specific cause of disease. See specific disease page for management.
Disposition
- Depending on how stable the patient is, patient can be admitted for work up or discharged for outpatient work up.
- Important to determine acute vs chronic symptoms.
See Also
- Sarcoidosis
- Idiopathic pulmonary fibrosis