00:01
As you go through this lecture series,
you wanna keep in mind that we are
causing collateral damage to the lung
and when you have such diseases that we'll
take a look at in this lecture series
including rheumatoid arthritis
and scleroderma and company,
then what kind of changes are taking place
in the lung is what you're asking yourself
and here we're still under the
category of restrictive lung disease
where FEV1 to FEC ratio
will never be decreased
First, well when you're dealing
with restrictive lung disease,
the differentiation and the fact that
you have so many different conditions
that may result in damage
to the interstitium
is then going to give you various
pathologic manifestations
but the algorithm that I will
show you in a second once again
is just to give you an idea as to where
on the map of interstitial lung disease
you are exactly located.
01:01
Always nice to know where you
are in terms of map, isn't it?
So many autoimmune diseases have
some pulmonary manifestations
So what are some of these autoimmune diseases
that you are extremely familiar with?
SLE, rheumatoid
arthritis, scleroderma
so those are the ones that
we are going to hit
usually within the diffused lung
disease category, but not always
But as far as you're concerned, the
type of presentation of your patient
when doing a pulmonary
function test
will be one in which it is suggestive
of restrictive lung disease
We'll discuss a nonspecific
type of interstitial pneumonias
what this commonly comes under
So many of these autoimmune
diseases in which you do have
collateral damage to the lung
in the form of interstitium
then pathologically or
histopathologically will then be defined
as being nonspecific
interstitial pneumonia.
02:01
Once again, just to make
sure that you're clear
here's that map that I've been referring
to with interstitial lung disease
and well, you don't have to
go through every single box
but if you give yourself one big clue
or one big differential in this group
at least it's giving yourself an idea as
to what that group is then referring to
thus far, under the category of diffuse
parenchymal or interstitial lung disease,
there were drugs that
we hadn't looked at
and with those drugs they include
your busulfan, amiodarone and company
and we looked at idiopathic
interstitial pneumonia
and then we walked through
nonfamilial and then
specifically went into chronic fibrosis
with idiopathic pulmonary fibrosis
and idiopathic pulmonary fibrosis
was the clinical diagnosis
Pathologically, you would then
find quite a bit of fibrosis
you remember the honeycomb
type of pattern
and then pathologically we then call
this "usual interstitial pneumonitis"
Current day practice, make sure
that you're familiar with the terms
and how to interchange them.
03:06
Those are the things that
we have discussed already.
03:09
So here, as we go through our
diffuse parenchymal lung disease,
we'll be focusing upon the
nonspecific interstitial pneumonia
in which we have autoimmune
diseases that is then
causing damage to the lung in
the area of the interstitium.