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Interstitial Pulmonary Fibrosis (Etiology (radiation, chemicals,…
Interstitial
Pulmonary
Fibrosis
Etiology
radiation
chemicals
environmental triggers
allergens
autoimmune
Idiopathic
Symptoms
Early
Fatigue
Dyspnea on exertion
Chronic unproductive cough
fever/sweat at night
weakness
Intermittent Claudication
Late
Finger clubbing
Decreased costal expansion
Crackles on auscultation
Cyanosis
monday morning blues
Worsening dyspnea
generalized aches and pains
Signs
Decreased lung volumes and capacities
Decreased lung compliance
Reduced diffusing capacity
Decreased PaO2 with exercise
PaO2 greatly reduced due to V/Q mismatch and thickened alveolar membrane
Decreased PaCO2 due to hyperventilation
Compensatory decrease in HCO3
Medical Management
Prednizone and other steroids
Oxygen based therapies
Supplemental O2
Regular use of oxygen
Azithromyosin
Eliminate bacteria that could cause interstitial pneumonia
Azathioprine
Suppresses the immune system
Allergen Response: hay breathed in with mold (antigen)
antigen build up in lungs
macrophages engulf antigen in lung
inflammatory process begun
repeated exposure to antigen
chronic inflammation
inflammation of alveoli
Membrane between alveoli and capillary to scar and thicken
Another way that oxygen transport decreases
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pulmonary fibrosis (alveoli)
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inflammatory cell/fibrocyte flock to injured area
repair
wound contraction
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apoptosis and phagocytosis
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Regeneration
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re-epithelialization
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cytokine, chemokine, GF release
inflammation of the bronchiole
bronchiole constriction
limited flow in/out of alveoli and decreased O2 prior to transport
Dx Testing
Imaging
Chest Xray
CT Scan
Echocardiogram
Lung Function tests
Pulmonary function testing
Pulse oximetry
Exercise stress test
Arterial blood gas test
Macrophages bunch together and make granulomas, decreasing lung surface area
Further causes restriction to the lungs
Intermittent claudication
decreased oxygen to the blood/body
Increased fatigue and shortness of breath with physical exertion
Increased workload of the heart to pump blood to the body
Potential cause of pulmonary hypertension