#29 Arfoosh - Diffuse Parenchymal Lung Diseases

Question 1

What imaging test is used to diagnose interstitial lung disease and what is seen?

Answer 1

HRCT - High resolution CT

Ground glass changes

Septal thickening

Honeycombing

Question 2

Describe the clinical manifestation of interstitial lung disease?

Answer 2

Progressive dyspnea

Non productive cough

Fatigue

Tachypnea

Course crackles

Clubbing

Peripheral cyanosis

Hempotesis

Pleuritic Chest pain

Question 3

What is seen on pulmonary function test for idiopathic pulmonary fibrosis?

Answer 3

Decreased:

FEV1

FVC

TLC

DLCO

Preserved:

FEV1/FVC Ratio

Question 4

Identify

Answer 4

Pulmonary Fibrosis

honeycombing

Question 5

40 year old AA femal. No PMH presenting with mild sob, worse on exerion, low grade fever, wrist joint pain and rash.

Plaque like erythematou lesions on legs b/l.

Answer 5

Sarcoidosis

Lofgren’s Syndrome (EN, BHA, Fever, migratory arthralgias)

Question 6

How would you treat sarcoidosis?

Answer 6

No therapy neede for mild cases.

Wait 6 months

Therapy if CNS/Cardiac/Eye/Hypercalcemia –>

1 -corticosteroids

2 - methotrexate

Question 7

Patient present with cough, dyspnea, low grade fever and fatigue. Birds. Lung exam is significant for inspiratory crackles nad mild expiratory wheezing. CT shows the cenral lobular with a ground glass appearance.

Answer 7

Hypersensitivity pneumonitis

Usually known exposure to offending agent.

Question 8

How would you treat hypersensitivity pneumonitis?

Answer 8

Avoid ongoing exposure

Glucocorticoid treatment w/prednisone