8 - ILD

Question 1

which gender tends to get more ILD in general?

Answer 1

women

Question 2

sx of ILDs

Answer 2

progressive dyspnea
dry cough
+/- wt loss

Question 3

PFT findings in ILDs

Answer 3

restrictive pattern
TLC reduction if severe
DLCO reduced

Question 4

connective tisue disease related ILD is in what category?

Answer 4

alveolitis/fibrotic

Question 5

idiopathic pulm fibrosis - demo, imaging, name of path process, general prog

Answer 5

old guys
reticular infiltrates, lower lobe mostly, subpleural, honeycombing in late stages
path = usual interstitial PNA
rapidly progressive, poor outcomes, death in ~2yrs

Question 6

Hamman Rich Syndrome

Answer 6

acute interstitial PNA > diffuse alveolar damage like an idiopathic ARDS
rare, but usually fulminant

Question 7

tx for idiopathic pulm fibrosis

Answer 7

supportive, only definitive tx is lung transplant

Question 8

nonspecific interstitial PNA - demo, imaging

Answer 8

middle aged smokers

diffuse ground glass infiltrates

Question 9

connective tissue dz (2) most commonly linked to ILD

Answer 9

SLE

RA

Question 10

MC pulm manifestation of SLE

Answer 10

pleuritis/pleural effusion

Question 11

asbestosis - imaging

Answer 11

irregular opacities in primarily lower lobes, may have pleural plaques/thickening

Question 12

silicosis - imaging

Answer 12

most in upper lobe/apex, hilar adenopathy (eggshell calcifications

Question 13

complication of silicosis

Answer 13

inc risk for TB

Question 14

sarcoidosis - demo, imaging

Answer 14

female, black, <40 yo

most common to have just LN enlargement, also get diffuse parenchymal lesions

Question 15

how pts w/ sarcoidosis often present

Answer 15

asymptomatic w/ abnl CXR (screening, taken for work, etc)

Question 16

outcomes of sarcoidosis

Answer 16

1/3 spontaneous remission in 3 yrs
1/3 stable
1/3 progressive

Question 17

tx for sarcoidosis

Answer 17

immunosuppression

Question 18

hypersensitivity pneumonitis - imaging, tx

Answer 18

diffuse small nodules of ground glass. Acute > upper lobe, chronic > lower lobe

avoidance of causative antigens if possible, corticosteroids may help

Question 19

cryptogenic organizing PNA - demo, specific sx/presentation, imaging, prognosis

Answer 19

older, no gender pref
sx of malaise, wt loss, myalgia, cough, dyspnea following resp infxn
patchy or diffuse infiltrates. On CT, see airspace ground glass opacities and bronchial wall thickening/dilation
good prognosis - 50% spontaneously remit

Question 20

tx of cryptogenic organizing PNA

Answer 20

steroids