Altered Immunological Activity Diseases

Question 1

What % of SLE patients will develop pleural or pulmonary disease?

Answer 1

50%

Question 2

What is the M/C pulmonary involvement with SLE individuals?

Answer 2

pleural disease

Question 3

What is the cause of the “shrinking lung syndrome” in SLE patients?

Answer 3

diaphragmatic dysfunction

Question 4

What is the M/C/C of death in SLE patients?

Answer 4

renal failure

Question 5

Extraarticular (eg. pulmonary) manifestations of rheumatoid disease is M/C in which gender?

Answer 5

men

Question 6

What is the water bottle sign in chest radiology?

Answer 6

The appearance of the heart in cases of cardiomegaly or pericardial effusion.

Question 7

What is the M/C pulmonary manifestation of RA?

Answer 7

interstitial pneumonia and fibrosis

Question 8

How do pulmonary rheumatoid nodules clinically present and where are they M/C located?

Answer 8

M/C asymptomatic.

M/C located in lung periphery and bases.

Question 9

Caplan’s syndrome has a predominance for which lobe?

Answer 9

upper lobe

Question 10

Progressive systemic sclerosis M/C affects which gender?

Answer 10

women

Question 11

What % of scleroderma patients have pulmonary disease at some point in their life?

Answer 11

75%

Question 12

Scleroderma has a predominance for which lobe?

Answer 12

lower lobe

Question 13

True or False: enlarged mediastinal nodes are rare in scleroderma.

Answer 13

False - seen in 60%

Question 14

What are the x-ray findings of scleroderma?

Answer 14

• progressive loss of lung volume d/t progressive fibrosis
• spontaneous pneumothorax d/t large cysts
• 50% enlarged central pulmonary arteries & R ventricular dilation d/t pulmonary arterial HTN

Question 15

What is the M/C/C of death in a patient with relapsing polychondritis?

Answer 15

recurrent pneumonia

Question 16

How commonly is the upper airway affected in relapsing polychondritis?

Answer 16

50%

Question 17

What % of Wegener’s granulomatosis patients have lung involvement. What % involves the upper respiratory tract?

Answer 17

90% lung involvement

~100% upper respiratory tract involved

Question 18

What is the M/C radiographic finding associated with Wegener’s?

Answer 18

multiple lung nodules/masses

Question 19

What is the headcheese sign what condition is it a hallmark sign for?

Answer 19

Hypersensitivity pneumonitis (aka extrinsic allergic alveolitis)

Question 20

Which organism is most commonly inhaled in farmer’s lung?

Answer 20

actinomyces

Question 21

What is Loeffler’s syndrome?

What unique radiographic feature is seen in Loeffler’s syndrome? Which other condition also presents with this finding?

Answer 21

aka. Simple eosinophilic lung disease
Self-limiting disease caused by hypersensitivity to drug therapy.

Reverse bat-wing appearance –> peripheral opacification
Also seen in chronic eosinophilic pneumonia

Question 22

What is the triad associated with Goodpasture’s syndrome?

Which gender does it affect most?

Answer 22

Triad

a) Glomerulonephritis
b) Pulmonary hemorrhage
c) Fe anemia

M:F = 4:1