p.3
Bronchiectasis and Its Symptoms
What does a left posterior oblique projection of a left bronchogram show in bronchiectasis?
It shows cylindrical bronchiectasis affecting the entire lower lobe except for the superior segment.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What do the same chemical mediators responsible for the alveolo-capillary damage of ARDS often cause?
Inflammation, endothelial damage, and capillary permeability throughout the body.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is exuded into the interstitium during acute lung injury?
Fluid, protein, and RBCs.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What severe condition impairs alveolar ventilation during acute lung injury?
Pulmonary edema and hemorrhage.
p.6
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What conditions can systemic diseases cause in the lungs?
Fibrosis, vasculitis, pulmonary hemorrhage, or granuloma formation.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is the most common cause of pulmonary edema?
Left-sided heart disease.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is another cause of pulmonary edema?
Capillary injury that increases capillary permeability.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What occurs as interstitial oncotic pressure begins to equal capillary oncotic pressure?
Water moves out of the capillary and into the lung.
p.8
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What occurs about 2 to 3 weeks after the initial injury in the fibrotic phase?
Remodeling and fibrosis occur.
p.6
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
Is there a specific treatment for lung involvement in systemic diseases?
There is usually no specific treatment, although corticosteroids often are used.
p.1
Mechanisms of Pleural Effusion
What may small pleural effusions not affect?
Lung function and they may remain undetected.
p.1
Empyema and Its Causes
What is empyema?
The presence of pus in the pleural space.
p.1
Restrictive Lung Disorders
What does decreased compliance of lung tissue in restrictive lung disorders mean?
It takes more effort to expand the lungs during inspiration, which increases the work of breathing.
p.8
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is the result of fibrosis obliterating the alveoli, respiratory bronchioles, and interstitium?
A decrease in functional residual capacity (FRC) and continuing V/Q mismatch with severe right-to-left shunt.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What occurs in the pulmonary circulation during acute lung injury?
Formation of microthrombi.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What diagnostic tools are used for pulmonary system assessment?
Chest x-ray, bronchoscopy, CT, and in some cases lung biopsy.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
How is the lung kept dry?
By lymphatic drainage and a balance among capillary hydrostatic pressure, capillary oncotic pressure, and capillary permeability.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
At what pressure does pulmonary edema usually begin to develop?
At a pulmonary capillary wedge pressure or left atrial pressure of 20 mmHg.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What can block lymphatic drainage?
Compression of lymphatic vessels caused by edema, tumors, and fibrotic tissue or by increased systemic venous pressure.
p.1
Mechanisms of Pleural Effusion
How are most small pleural effusions removed?
By the lymphatic system once the underlying condition is resolved.
p.1
Empyema and Its Causes
How is empyema thought to develop?
When the pulmonary lymphatics become blocked, leading to an outpouring of contaminated lymphatic fluid into the pleural space.
p.1
Restrictive Lung Disorders
What do individuals with lung restriction complain of?
Dyspnea and have an increased respiratory rate and decreased tidal volume.
p.1
Aspiration and Its Complications
What is the risk associated with individuals who require enteral feeding?
The risk of aspiration and development of pneumonia.
p.3
Bronchiectasis and Its Symptoms
What indicates volume loss of the lower lobe in bronchiectasis?
The basal airways are crowded together.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is the result of the overwhelming inflammatory response by the lungs?
Acute respiratory failure.
p.6
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What can several systemic diseases affect in the pulmonary system?
The airways, pleurae, or lung parenchyma.
p.6
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is angioimmunoblastic or immunoblastic lymphadenopathy?
A disease of the lymph nodes.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What are predisposing factors for pulmonary edema?
Heart disease, ARDS, and inhalation of toxic gases.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is postobstructive pulmonary edema (POPE)?
A rare life-threatening complication.
p.1
Mechanisms of Pleural Effusion
What occurs in a large, rapidly developing pleural effusion?
Mediastinal shift and cardiovascular manifestations.
p.1
Empyema and Its Causes
What are common causes of empyema?
Complications of pneumonia, surgery, trauma, or bronchial obstruction from a tumor.
p.2
Aspiration and Its Complications
What can aspiration of oral or pharyngeal secretions lead to?
Aspiration of oral or pharyngeal secretions can lead to aspiration pneumonia.
p.2
Aspiration and Its Complications
What happens in the alveoli when acidic fluid is aspirated?
Acidic fluid damages the alveolocapillary membrane, allowing plasma and blood cells to move from capillaries into the alveoli, resulting in hemorrhagic pneumonitis.
p.2
Aspiration and Its Complications
Why are antacids sometimes given to individuals at risk for aspiration?
Antacids are sometimes given to individuals at risk for aspiration to keep gastric pH greater than 2.5.
p.2
Aspiration and Its Complications
When may corticosteroids be administered after aspiration?
Corticosteroids may be administered during the first 72 hours after aspiration.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is released during acute lung injury?
Inflammatory cytokines (e.g. IL-1, IL-6, TNF).
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What occurs during V/Q mismatching in acute lung injury?
Proliferation of type II pneumocytes, fibroblasts, and myofibroblasts.
p.6
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
How is the diagnosis of lung involvement in systemic diseases usually made?
Based on involvement of other organs.
p.6
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are some connective tissue diseases that affect the lung?
Rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polymyositis or dermatomyositis, Sjögren syndrome, and polyarteritis nodosa.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is pulmonary edema?
Excess water in the lung.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
When does pulmonary edema develop?
When the flow of fluid out of the capillaries exceeds the lymphatic system’s ability to remove it.
p.1
Types of Pleural Effusion
What are the types of pleural effusion characterized by?
The presence of pus (empyema), blood (hemothorax), or chyle (chylothorax).
p.1
Mechanisms of Pleural Effusion
What may be required if the pleural effusion is large?
Drainage usually requires the placement of a chest tube and surgical interventions may be needed to prevent recurrence.
p.1
Empyema and Its Causes
How is the diagnosis of empyema made?
By chest radiographs, thoracentesis, and sputum culture.
p.1
Restrictive Lung Disorders
What characterizes restrictive lung disorders?
Decreased compliance of lung tissue.
p.1
Aspiration and Its Complications
What are predisposing factors for aspiration?
Altered level of consciousness caused by substance abuse, sedation, or anesthesia; seizure disorders; cerebrovascular accident; and neuromuscular disorders that cause dysphagia.
p.3
Atelectasis Types and Causes
What causes absorption atelectasis?
Lack of collateral ventilation through pores of Kohn.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What may death be caused by in association with ARDS?
MODS associated with ARDS.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is the result of acute respiratory failure?
Hypoxemia, hypercapnea, and acidosis.
p.6
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
How are clinical manifestations of lung involvement usually characterized?
They are usually nonspecific.
p.6
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is Goodpasture syndrome?
A pulmonary and renal disorder.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
Where does fluid move after entering the interstitium?
To the lymphatic vessels and is then removed from the lung.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What happens when plasma proteins move into the lung interstitium?
They increase the interstitial oncotic pressure.
p.1
Aspiration and Its Complications
In which individuals does aspiration tend to occur?
In individuals whose normal swallowing mechanism and cough reflex are impaired by a decreased level of consciousness or central nervous system abnormalities.
p.2
Aspiration and Its Complications
What happens if the aspirated solid is not identified and removed by bronchoscopy?
A chronic, local inflammation develops that may lead to recurrent infection and bronchiectasis.
p.2
Aspiration and Its Complications
What symptoms might some individuals with aspiration experience over months and even years?
Some individuals have recurrent lung infections, chronic cough, or persistent wheezing over months and even years.
p.2
Aspiration and Its Complications
What can nasogastric tubes cause if fluid and particulate matter are regurgitated as the tube is being placed?
Nasogastric tubes can cause aspiration if fluid and particulate matter are regurgitated as the tube is being placed.
p.3
Bronchiectasis and Its Symptoms
What are the types of bronchiectasis?
Saccular, varicose, and cylindrical.
p.8
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does the fibrosis progressively obliterate?
The alveoli, respiratory bronchioles, and interstitium.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What cells influx during acute lung injury?
Inflammatory cells (neutrophils, macrophages, platelets).
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does treatment for certain pulmonary conditions consist of?
Avoidance of the offending agent and corticosteroid administration.
p.6
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are some systemic diseases that affect the lung?
Granulomatous disorders such as sarcoidosis, Wegener granulomatosis, lymphomatoid granulomatosis, and eosinophilic granuloma.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does surfactant lining the alveoli do?
Repels water, keeping fluid from entering the alveoli.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What happens if capillary oncotic pressure is decreased?
Pulmonary edema develops at a lower hydrostatic pressure.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What can happen in left-sided heart failure?
Increased systemic venous pressure that elevates the hydrostatic pressure of the large pulmonary veins into which the pulmonary lymphatic system drains.
p.1
Mechanisms of Pleural Effusion
What are common symptoms of pleural effusion?
Dyspnea, compression atelectasis with impaired ventilation, and pleural pain.
p.1
Empyema and Its Causes
In which populations does empyema occur most commonly?
In older adults and children.
p.1
Empyema and Its Causes
What does the treatment for empyema include?
The administration of appropriate antimicrobials and drainage of the pleural space with a chest tube.
p.2
Aspiration and Its Complications
What does bronchial damage include?
Bronchial damage includes inflammation, loss of ciliary function, and bronchospasm.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What can occur after relief of upper airway obstruction?
Postextubation laryngospasm after anesthesia, epiglottitis, laryngeal tumor, or obstructive tonsils.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What might physical examination reveal in pulmonary edema?
Inspiratory crackles (rales), dullness to percussion over the lung bases, and evidence of ventricular dilation (S3 gallop and cardiomegaly).
p.2
Atelectasis Types and Causes
What is atelectasis?
Atelectasis is the collapse of lung tissue.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is the estimated incidence of ALI/ARDS in the United States?
64 to 78 cases per 100,000 people.
p.3
Atelectasis Types and Causes
How is collateral ventilation restored during deep breathing?
Through the opening of pores of Kohn.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What are some examples of acute lung injury?
Pneumonia, aspiration, smoke inhalation, sepsis.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What cells are damaged during acute lung injury?
Alveolar and endothelial cells.
p.8
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What happens during the fibrotic phase of acute lung injury?
Progressive fibrosis and tissue remodeling, leading to destruction of alveoli and bronchioles.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What happens when the left ventricle fails?
Filling pressures on the left side of the heart increase and cause a concomitant increase in pulmonary capillary hydrostatic pressure.
p.1
Empyema and Its Causes
What are the clinical presentations of individuals with empyema?
Cyanosis, fever, tachycardia (rapid heart rate), cough, and pleural pain.
p.2
Aspiration and Its Complications
What are the serious consequences of aspirating large food particles or gastric fluid with a pH of less than 2.5?
Aspiration of large food particles or gastric fluid with a pH of less than 2.5 has serious consequences.
p.2
Aspiration and Its Complications
What may develop as the process of aspiration progresses?
Hypoventilation may develop as this process progresses.
p.2
Aspiration and Its Complications
How should individuals who have difficulty swallowing be fed?
Individuals who have difficulty swallowing are fed with extreme caution and positioned to minimize the likelihood of aspiration.
p.2
Aspiration and Its Complications
Why are fluids restricted in the treatment of aspiration, pneumonia, or pneumonitis?
Fluids are restricted to decrease blood volume and minimize pulmonary edema.
p.2
Atelectasis Types and Causes
What can cause atelectasis at the base of the lungs?
Atelectasis at the base of the lungs can be caused by abdominal distention pressing on a portion of the lung, causing the alveoli to collapse.
p.2
Atelectasis Types and Causes
When does atelectasis tend to occur?
Atelectasis tends to occur after surgery and with use of general anesthesia.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What are the most common predisposing factors for ARDS?
Genetic factors, sepsis, and multiple trauma.
p.2
Bronchiectasis and Its Symptoms
What can chronic inflammation of the bronchi lead to?
Chronic inflammation of the bronchi leads to destruction of elastic and muscular components of their walls, bronchial lumen obstruction, traction from adjacent fibrosis, and permanent dilation.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What are thrombi in ARDS composed of?
Aggregated neutrophils, macrophages, platelets, and fibrin.
p.4
Bronchiectasis and Its Symptoms
What is the primary symptom of bronchiectasis?
Chronic productive cough.
p.4
Bronchiectasis and Its Symptoms
What may be indicated for selected individuals with localized areas of bronchiectasis involvement?
Surgery to remove the affected portion of the lung.
p.4
Bronchiolitis and Its Clinical Manifestations
What may occur as lung restriction worsens in bronchiolitis?
A decrease in minute ventilation with resulting carbon dioxide retention.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What do asbestos fibers cause?
Inflammation and alveolitis.
p.3
Bronchiectasis and Its Symptoms
How far can the dilated bronchi and bronchioles be dissected in cylindrical bronchiectasis?
Almost to the pleural surface.
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does the systemic inflammatory response syndrome (SIRS) lead to?
Multiple organ dysfunction syndrome (MODS).
p.8
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What do neutrophils release during acute lung injury?
Mediators (ROS, proteolytic enzymes, cytokines, PAF).
p.8
Atelectasis Types and Causes
What occurs to the lungs during the exudative phase of acute lung injury?
Atelectasis and decreased lung compliance.
p.6
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is cystic fibrosis?
A systemic disease affecting the lung.
p.6
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What occurs when hydrostatic pressure exceeds oncotic pressure?
Fluid moves into the interstitium, or interstitial space.
p.1
Mechanisms of Pleural Effusion
How is the diagnosis of pleural effusion confirmed?
By chest x-ray and thoracentesis (needle aspiration).
p.2
Aspiration and Its Complications
What can solid food particles cause when aspirated?
Solid food particles can obstruct a bronchus, resulting in bronchial inflammation and collapse of airways distal to the obstruction.
p.2
Aspiration and Its Complications
What can intubation of the trachea cause?
Intubation of the trachea can cause aspiration and bacterial pneumonia.
p.2
Aspiration and Its Complications
What are the clinical manifestations of aspiration?
Clinical manifestations of aspiration include the sudden onset of choking and intractable cough with or without vomiting, fever, dyspnea, and wheezing.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does excessive intrathoracic negative pressure cause?
Increased venous return and blood flow to the right side of the heart and decreased outflow from the left side of the heart from the increased afterload.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is the current death rate for ALI/ARDS?
Approximately 42% to 47%.
p.2
Atelectasis Types and Causes
Why is deep breathing beneficial?
Deep breathing is beneficial because it promotes the ciliary clearance of secretions, stabilizes the alveoli by redistributing surfactant, and permits collateral ventilation of the alveoli through pores of Kohn.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does lung inflammation and injury damage in ARDS?
The alveolar epithelium and the vascular endothelium.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What results from pulmonary vasoconstriction in ARDS?
V/Q mismatching and early pulmonary hypertension.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does pneumoconiosis represent?
Any change in the lung caused by inhalation of inorganic dust particles, usually occurring in the workplace.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does the deposition of these materials in the lungs cause?
The release of proinflammatory cytokines (e.g., interleukin-1-beta).
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What may decrease in pulmonary fibrosis, causing hypoxemia?
The diffusing capacity of the alveolocapillary membrane.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is the most common idiopathic interstitial lung disorder?
Idiopathic pulmonary fibrosis (IPF).
p.1
Mechanisms of Pleural Effusion
What does physical examination reveal in pleural effusion?
Decreased breath sounds and dullness to percussion on the affected side.
p.1
Empyema and Its Causes
What are commonly documented infectious microorganisms in empyema?
Staphylococcus aureus, Escherichia coli, anaerobic bacteria, and Klebsiella pneumoniae.
p.1
Empyema and Its Causes
What may be needed in severe cases of empyema to achieve adequate drainage?
Ultrasound-guided pleural drainage, instillation of fibrinolytic agents, or deoxyribonuclease (DNase) injected into the pleural space.
p.1
Restrictive Lung Disorders
What can restrictive lung diseases cause?
Ventilation and perfusion mismatch and affect the alveolocapillary membrane.
p.1
Aspiration and Its Complications
What is aspiration?
The passage of fluid and solid particles into the lung.
p.2
Aspiration and Its Complications
How does the branching angle of the right mainstem bronchus compare to the left mainstem bronchus?
The right mainstem bronchus is straighter than the branching angle of the left mainstem bronchus.
p.2
Aspiration and Its Complications
What happens to the lung when surfactant production is disrupted?
The lung becomes stiff and noncompliant, leading to further edema and collapse.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does attempted inspiration against an occluded airway create?
Excessive intrathoracic negative pressure.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What happens in severe pulmonary edema?
Pink, frothy sputum is expectorated, hypoxemia worsens, and hypoventilation with hypercapnia may develop.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
How is POPE treated?
With positive end-expiratory pressure ventilation.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What other health problems may survivors of ALI/ARDS have up to 5 years later?
Neurocognitive disorders.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
How can alveolocapillary injury occur indirectly?
From circulating inflammatory mediators released in response to systemic disorders, such as sepsis and trauma.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What do mediators released by neutrophils and macrophages cause in ARDS?
Pulmonary vasoconstriction.
p.4
Bronchiectasis and Its Symptoms
What abnormalities develop in bronchiectasis and result in hypoxemia?
Ventilation-perfusion abnormalities.
p.4
Bronchiectasis and Its Symptoms
What treatments are used for bronchiectasis?
Sputum culture antibiotics, bronchodilators, anti-inflammatory drugs, chest physiotherapy, and supplemental oxygen.
p.5
Bronchiectasis and Its Symptoms
What conditions may cause deterioration after initial improvement in acute toxic inhalation?
Bronchiectasis or bronchiolitis.
p.4
Bronchiolitis and Its Clinical Manifestations
In which condition is bronchiolitis obliterans most common?
After lung transplantation.
p.4
Bronchiolitis and Its Clinical Manifestations
How is the diagnosis of bronchiolitis obliterans made?
By spirometry and bronchoscopy with biopsy.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
How is pneumoconiosis usually diagnosed?
By performing chest x-ray or CT and by obtaining a careful occupational history.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does acute inflammation in silicosis contribute to?
Bronchospasm and wheezing.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is frequently inhaled with coal dust?
A mixture of coal, silica, and quartz, which is strongly inflammatory.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What symptoms are seen in individuals with advanced coal worker pneumoconiosis?
A productive cough and wheezing.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What causes asbestosis?
Inhalation of hydrous silicates of various metals in fibrous form.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are the most prominent clinical manifestations of asbestosis with fibrosis?
Dyspnea on exertion, a nonproductive cough, diffuse inspiratory crackles on examination, hypoxemia, and decreased lung volume.
p.1
Restrictive Lung Disorders
What are some of the most common restrictive lung diseases in adults?
Aspiration, atelectasis, bronchiectasis, bronchiolitis, pulmonary fibrosis, inhalational disorders, pneumoconiosis, allergic alveolitis, pulmonary edema, and acute respiratory distress syndrome.
p.1
Aspiration and Its Complications
Why is the right lung, particularly the right lower lobe, more susceptible to aspiration than the left lung?
Because the branching angle of the right main bronchus is more vertical.
p.2
Aspiration and Its Complications
What may aspiration of acidic gastric fluid cause?
Aspiration of acidic gastric fluid may cause severe pneumonitis.
p.2
Aspiration and Its Complications
What are the most important preventive measures for aspiration?
The most important preventive measures include use of a semirecumbent position, surveillance of enteral feeding, use of promotility agents, and avoidance of excessive sedation.
p.2
Aspiration and Its Complications
Who can often improve swallowing abilities to prevent recurrence in individuals with swallowing difficulties?
Speech-language pathologists can often improve swallowing abilities that may prevent recurrence.
p.2
Aspiration and Its Complications
What must be treated with broad-spectrum antibiotics as a complication of aspiration pneumonitis?
Bacterial pneumonia must be treated with broad-spectrum antibiotics.
p.2
Atelectasis Types and Causes
What results in surfactant impairment?
Surfactant impairment results from decreased production or inactivation of surfactant, which is necessary to reduce surface tension in the alveoli and thus prevent lung collapse during expiration.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
Who continues to have a much higher mortality in ALI/ARDS?
Older people and those who have severe infections or are immunocompromised.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What do all disorders that result in ARDS cause?
Acute injury to the alveolocapillary membrane producing massive pulmonary inflammation, increased capillary permeability, severe pulmonary edema, shunting, V/Q mismatch, and hypoxemia.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
Why is ARDS often referred to as non-cardiogenic pulmonary edema?
Because the pulmonary edema is not secondary to heart failure.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What do activated neutrophils release in ARDS?
A battery of harmful inflammatory mediators, including proteolytic enzymes, oxygen free radicals, arachidonic acid metabolites, and platelet-activating factor.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What happens during the proliferative phase of ARDS?
There is resolution of the pulmonary edema and proliferation of type II pneumocytes, fibroblasts, and myofibroblasts.
p.4
Bronchiectasis and Its Symptoms
What happens to the smaller bronchial divisions in varicose and saccular bronchiectases?
They are plugged with secretions or obliterated by fibrosis.
p.4
Bronchiolitis and Its Clinical Manifestations
What conditions can bronchiolitis occur with in adults?
Chronic bronchitis or an upper or lower airway viral infection.
p.5
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
Are corticosteroids effective in treating acute toxic inhalation?
Their effectiveness has not been well documented.
p.4
Bronchiolitis and Its Clinical Manifestations
What treatments are used for bronchiolitis?
Appropriate antibiotics, steroids, and chest physical therapy.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
When does pneumoconiosis often occur?
After years of exposure to the offending dust with progressive fibrosis of lung tissue.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What industries are involved with silica exposure?
Mining and industries involved with the extraction and processing of ores; preparation and use of sand; and manufacture of pipe, building, and roofing materials.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
Is there a curative treatment for silicosis?
No, although corticosteroids may produce some improvement in the early, more acute stages.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What leads to increased work of breathing in idiopathic pulmonary fibrosis (IPF)?
Decreased lung compliance.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What allergens can cause hypersensitivity pneumonitis?
Grains, silage, bird droppings or feathers, wood dust, cork dust, animal pelts, coffee beans, fish meal, mushroom compost, grain molds, mists from standing water, and fumes from paints and resins.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are the symptoms of acute allergic alveolitis?
Fever, cough, dyspnea, and chills a few hours after exposure that resolve without treatment in 1 to 3 days.
p.2
Aspiration and Its Complications
What is usually required once the pathologic process has progressed to bronchiectasis?
Surgical resection of the affected area is usually required.
p.2
Aspiration and Its Complications
What are more effective than treatment of known aspiration?
Preventive measures for individuals at risk are more effective than treatment of known aspiration.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What combination of events leads to pulmonary edema?
Increased pulmonary blood volume and venous pressure.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is the therapy for pulmonary edema caused by increased hydrostatic pressure from heart failure?
Improving cardiac output and volume status with diuretics, vasodilators, and drugs that improve the contraction of the heart muscle.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
When might mechanical ventilation be needed in pulmonary edema?
If edema significantly impairs ventilation and oxygenation.
p.2
Atelectasis Types and Causes
What do individuals produce that tends to pool in dependent portions of the lung after surgical procedures?
Individuals produce viscous secretions that tend to pool in dependent portions of the lung after surgical procedures.
p.2
Atelectasis Types and Causes
What do the pores of Kohn allow during deep breathing?
The pores of Kohn allow air to pass from well-ventilated alveoli to obstructed alveoli, minimizing their tendency to collapse and facilitating expectoration of the bronchial obstruction.
p.2
Bronchiectasis and Its Symptoms
What are the types of bronchial dilation in bronchiectasis?
Bronchial dilation may be cylindrical, saccular, or varicose.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What are the consequences of surfactant inactivation in ARDS?
The lungs become less compliant, the work of breathing increases, ventilation of alveoli decreases, and hypercapnia develops.
p.4
Bronchiectasis and Its Symptoms
What happens to the sputum if the individual with bronchiectasis is not receiving antibiotics?
The sputum has a foul odor.
p.4
Bronchiolitis and Its Clinical Manifestations
What are the clinical manifestations of bronchiolitis?
Rapid ventilatory rate, marked use of accessory muscles, low-grade fever, dry non-productive cough, and hyperinflated chest.
p.5
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is the basic underlying mechanism of injury in oxygen toxicity?
A severe inflammatory response mediated primarily by oxygen free radicals.
p.4
Bronchiolitis and Its Clinical Manifestations
What fills the alveoli and bronchioles in bronchiolitis obliterans organizing pneumonia (BOOP)?
Plugs of connective tissue.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is pulmonary fibrosis?
An excessive amount of fibrous or connective tissue in the lung.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is silicosis?
A type of pneumoconiosis resulting from the inhalation of free silica (silicon dioxide) and silica-containing compounds.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does fibrosis cause in the lungs?
A marked loss of lung compliance.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What increases the risk for lung cancer in silicosis?
Release of proteolytic enzymes and toxic oxygen free radicals.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does the advanced form of coal worker pneumoconiosis manifest as?
Severe pulmonary fibrosis.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What do individuals with more complicated forms of coal worker pneumoconiosis often develop?
Marked cardiopulmonary dysfunction.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is hypersensitivity pneumonitis (extrinsic allergic alveolitis)?
An allergic, inflammatory disease of the lungs caused by inhalation of organic particles or fumes.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are the symptoms of chronic allergic alveolitis?
Weight loss, fever, fatigue, and gradually progressive respiratory failure.
p.2
Aspiration and Its Complications
What should individuals being administered general anesthetics avoid?
Individuals being administered general anesthetics should not receive food or fluid for several hours before or after surgery.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What are the clinical manifestations of pulmonary edema?
Dyspnea, orthopnea, hypoxemia, and increased work of breathing.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is the treatment for pulmonary edema resulting from increased capillary permeability due to injury?
Removing the offending agent and supportive therapy to maintain adequate oxygenation, ventilation, and circulation.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) represent?
A spectrum of acute lung inflammation and diffuse alveolocapillary injury.
p.2
Atelectasis Types and Causes
What are the clinical manifestations of atelectasis?
Clinical manifestations of atelectasis are similar to those of pulmonary infection: dyspnea, cough, fever, and leukocytosis.
p.2
Bronchiectasis and Its Symptoms
What is bronchiectasis?
Bronchiectasis is persistent abnormal dilation of the bronchi.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What are the three overlapping phases of ARDS characterized by?
Histologic changes in the lung: exudative (inflammatory), proliferative, and fibrotic.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What do the mediators released by neutrophils cause in ARDS?
Extensive damage to the alveolocapillary membrane and greatly increased capillary membrane permeability.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does the intra-alveolar hemorrhagic exudate become in the proliferative phase of ARDS?
A cellular granulation tissue appearing as hyaline membranes.
p.4
Bronchiectasis and Its Symptoms
What develops between the bronchial and pulmonary blood vessels in bronchiectasis?
Large anastomoses (connections).
p.4
Bronchiectasis and Its Symptoms
What can cause hemoptysis in bronchiectasis?
Mucosal inflammation and necrosis.
p.5
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What complications frequently arise from acute toxic inhalation?
The development of ARDS and pneumonia.
p.5
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What are the results of oxygen toxicity?
Damage to alveolocapillary membranes, disruption of surfactant production, interstitial and alveolar edema, and decrease in compliance.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is thought to cause idiopathic pulmonary fibrosis (IPF)?
Multiple injuries at different sites of the lung followed by aberrant repair.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What do symptoms of advanced coal worker pneumoconiosis mimic?
Those of chronic bronchitis and emphysema.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What do activated macrophages release in asbestosis?
Toxic oxygen free radicals.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What do toxic oxygen free radicals cause in asbestosis?
Cellular apoptosis, leading to both fibrosis and malignancy.
p.2
Aspiration and Its Complications
What does treatment of aspiration, pneumonia, or pneumonitis include?
Treatment includes supplemental oxygen and may require mechanical ventilation with positive end-expiratory pressure (PEEP).
p.2
Atelectasis Types and Causes
What causes compression atelectasis?
Compression atelectasis is caused by external pressure exerted on lung tissue, such as with tumors, or by fluid or air in the pleural space.
p.2
Atelectasis Types and Causes
What can cause surfactant impairment?
Surfactant impairment can occur because of premature birth, acute respiratory distress syndrome, anesthesia, or mechanical ventilation.
p.2
Atelectasis Types and Causes
What does prevention and treatment of postoperative atelectasis usually include?
Prevention and treatment of postoperative atelectasis usually include deep breathing exercises, frequent position changes, and early ambulation.
p.2
Bronchiectasis and Its Symptoms
What conditions are usually associated with bronchiectasis?
Bronchiectasis usually occurs in conjunction with other respiratory conditions associated with chronic bronchial inflammation.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What inflammatory mediators are involved in the exudative phase of ARDS?
Complement, cytokines, arachidonic acid metabolites, platelet-activating factor, reactive oxygen species, and other mediators (specifically TNF, IL-1, and IL-6).
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What happens in ARDS caused by sepsis?
Bacterial toxins are recognized by the CD14 receptors on macrophages, leading to chemotaxis of large numbers of neutrophils to the lungs.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does the resulting pulmonary edema and hemorrhage in ARDS cause?
Severely reduced lung compliance and impaired alveolar ventilation.
p.4
Bronchiectasis and Its Symptoms
What does airway damage lead to in bronchiectasis?
Bronchospasm and copious production of purulent mucus.
p.4
Bronchiectasis and Its Symptoms
How is the diagnosis of bronchiectasis usually confirmed?
By the use of high-resolution CT.
p.5
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What are the initial symptoms of acute toxic inhalation?
Burning of the eyes, nose, and throat; coughing; chest tightness; and dyspnea.
p.4
Bronchiolitis and Its Clinical Manifestations
How quickly can respiratory distress develop in bronchiolitis caused by inhalation injury?
Within 24 to 72 hours with severe hypoxia.
p.5
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does treatment for oxygen toxicity involve?
Ventilatory support and reduction of inspired oxygen concentration to less than 60%, as soon as tolerated.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What other materials can cause pneumoconiosis?
Talc, fiberglass, clays, mica, slate, cement, cadmium, beryllium, tungsten, cobalt, aluminum, and iron.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is idiopathic pulmonary fibrosis?
Pulmonary fibrosis with no specific known cause.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does silica exposure activate?
Innate and adaptive immune mechanisms, and triggers inflammation with subsequent fibrosis.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What causes coal worker pneumoconiosis (coal miner lung, black lung)?
Coal dust deposits in the lung.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
How is coal worker pneumoconiosis diagnosed?
By obtaining a history of exposure and observing chest radiographs for characteristic signs.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is the prognosis for individuals with the mild form of coal worker pneumoconiosis?
They usually have a favorable prognosis.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
Who can be affected by asbestos exposure?
Factory workers and individuals who live in areas of asbestos emission.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
How is hypersensitivity pneumonitis diagnosed?
By obtaining a history of allergen exposure and performing serum antibody testing.
p.2
Atelectasis Types and Causes
What results in absorption atelectasis?
Absorption atelectasis results from gradual absorption of air from obstructed or hypoventilated alveoli or from inhalation of concentrated oxygen or anesthetic agents.
p.2
Atelectasis Types and Causes
What are individuals often in pain, breathe shallowly, and reluctant to do after surgery?
Individuals are often in pain, breathe shallowly, and are reluctant to change position after surgery.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What are some other causes of ARDS?
Pneumonia, burns, aspiration, cardiopulmonary bypass surgery, pancreatitis, drug overdose, smoke or noxious gas inhalation, oxygen toxicity, radiation therapy, and disseminated intravascular coagulation.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What results from activated complement factors and platelet aggregation in ARDS?
Intravascular microthrombus formation and further damage to lung capillaries.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is released by macrophages in response to bacterial toxins in ARDS?
A cascade of inflammatory mediators, including TNF, IL-1, alpha and beta chemokines, and other interleukins.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What happens to surfactant in ARDS?
It is inactivated, and its production by type II alveolar cells is impaired as alveoli and respiratory bronchioles fill with fluid or collapse.
p.4
Bronchiectasis and Its Symptoms
What is bronchiectasis commonly associated with?
Recurrent lower respiratory tract infections and expectoration of voluminous amounts of foul-smelling purulent sputum.
p.4
Bronchiolitis and Its Clinical Manifestations
What is bronchiolitis?
Diffuse inflammation of the small airways or bronchioles.
p.5
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What treatments are used for acute toxic inhalation?
Supplemental oxygen, mechanical ventilation with PEEP, and support of the cardiovascular system.
p.4
Bronchiolitis and Its Clinical Manifestations
How is the diagnosis of bronchiolitis made?
By spirometry and bronchoscopy with biopsy.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What is important in determining the diagnosis of pneumoconiosis?
The individual’s history of exposure.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does chronic inflammation with scarring of the alveolocapillary membrane result in?
Pulmonary fibrosis and progressive pulmonary deterioration.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are the specific causes of pulmonary fibrosis?
Inhalation of harmful substances and underlying autoimmune systemic disorders.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
In which demographic is idiopathic pulmonary fibrosis (IPF) more common?
More common in men than in women and most cases occur after age 60.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are the symptoms of the mild form of coal worker pneumoconiosis?
It is asymptomatic, except for possible chronic bronchitis.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What has a higher success rate but also higher toxicity in treating idiopathic pulmonary fibrosis (IPF)?
Combined treatment with cytotoxic drugs.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does progressive asbestosis disease lead to?
Respiratory failure and cardiac complications.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does continued exposure to allergens in hypersensitivity pneumonitis result in?
A type IV cellular immune activation.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What may increase the risk for hypersensitivity pneumonitis?
A genetic predisposition.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What happens with continued exposure in hypersensitivity pneumonitis?
The disease becomes chronic and pulmonary fibrosis develops.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What is the lung function status of most survivors of ALI/ARDS one year after the acute illness?
Almost normal lung function.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
How can alveolocapillary injury occur directly?
Through the aspiration of highly acidic gastric contents or the inhalation of toxic gases.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What happens during the exudative (inflammatory) phase of ARDS?
The initial lung injury damages the alveolocapillary membrane, activating neutrophils, platelets, macrophages, lung epithelial and endothelial cells, and uncontrolled inflammation.
p.7
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
What does increased capillary permeability in ARDS allow?
Fluids, proteins, and blood cells to leak from the capillary bed into the pulmonary interstitium and alveoli.
p.4
Bronchiectasis and Its Symptoms
What is thought to cause hemoptysis in individuals with bronchiectasis?
The large anastomoses between the bronchial and pulmonary blood vessels.
p.4
Bronchiectasis and Its Symptoms
What do pulmonary function studies show in bronchiectasis?
Decreases in FVC and expiratory flow rates.
p.4
Bronchiolitis and Its Clinical Manifestations
What may develop distal to the inflammatory lesion in bronchiolitis?
Atelectasis or emphysematous destruction of the alveoli.
p.5
Acute Lung Injury and Acute Respiratory Distress Syndrome (ARDS)
How do most individuals respond to therapy for acute toxic inhalation?
Most individuals respond quickly to therapy.
p.4
Bronchiolitis and Its Clinical Manifestations
What is bronchiolitis obliterans?
A late-stage fibrotic process that occludes the airways and causes permanent scarring of the lungs.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are the most common causes of pneumoconiosis?
The dusts of silica, asbestos, and coal.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are the clinical manifestations with the advancement of pneumoconiosis?
Cough, sputum production, dyspnea, decreased lung volumes, and hypoxemia.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What happens to the lung in pulmonary fibrosis?
It becomes stiff and difficult to ventilate.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
When do clinical manifestations of silicosis appear?
They include cough and dyspnea when clinical manifestations do appear.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does the disruption of the alveolocapillary basement membrane cause in idiopathic pulmonary fibrosis (IPF)?
Decreased oxygen diffusion across the alveolocapillary membrane and hypoxemia.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are the primary symptoms of idiopathic pulmonary fibrosis (IPF)?
Increasing dyspnea on exertion and diffuse inspiratory crackles.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
How is the diagnosis of idiopathic pulmonary fibrosis (IPF) confirmed?
By pulmonary function testing (decreased FVC), high-resolution CT, and lung biopsy.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are some newer therapies for idiopathic pulmonary fibrosis (IPF)?
Antifibrotic drugs (such as N-acetylcysteine and pirfenidone), interferon, and anticoagulation.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What conditions can asbestos exposure result in?
A type of pulmonary fibrosis called asbestosis, lung cancer, mesothelioma (cancer of the pleura), or pleural plaques.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What type of immune response is initiated by alveolar macrophages in hypersensitivity pneumonitis?
A type III immune response.
p.4
Bronchiolitis and Its Clinical Manifestations
What can bronchiolitis obliterans be further complicated by?
The development of pneumonia (bronchiolitis obliterans organizing pneumonia [BOOP]).
p.4
Bronchiolitis and Its Clinical Manifestations
What treatments are used for bronchiolitis obliterans?
Corticosteroids and other immunomodulatory agents.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What does treatment for pneumoconiosis usually focus on?
Preventing further exposure, improving working conditions, pulmonary rehabilitation, and management of associated hypoxemia and bronchospasm.
p.4
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What occurs around the alveoli in idiopathic pulmonary fibrosis (IPF)?
Chronic inflammation and fibroproliferation of the interstitial lung tissue.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What increases the risk of asbestos-related diseases?
Exposure to cigarette smoke.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
How is asbestosis diagnosed?
By chest x-ray, pulmonary function testing, and CT.
p.5
Pulmonary Fibrosis and Idiopathic Pulmonary Fibrosis
What are reduced in hypersensitivity pneumonitis?
Lung capacity and alveolocapillary diffusion.
