Chpt 26-Interstitial Lung Disease

Question 1

What impairs gas exchange in interstitial lung disease

Answer 1

Vq mismatching
Shunt
Decreased diffusion across interstitium

Question 2

Signs and symptoms of ild

Answer 2

Dyspnea

Nonproductive cough

Question 3

What are breath sounds with ild

Answer 3

Bilateral fine inspiratory crackles

Question 4

What does chest X-ray with ild look like

Answer 4

Reduced lung volume with bilateral opacities

Ipf will have honeycomb appearance

Question 5

What will present on pft for ild

Answer 5

Restrictive pattern
Reduced lung volumes
Reduced dlco

Question 6

Normal spirometry but reduced dlco suggests?

Answer 6

Ipf and emphysema

Question 7

Patients who develop ground glass opacities within 6. Months of radiation can be treated with

Answer 7

Oral corticosteroids for acute inflammation

Question 8

Treatment for patients who develop ild more than 6 months post radiation can be treated with

Answer 8

Supportive care only, corticosteroids don’t help

Question 9

Bleomycin induced ild is made worse by

Answer 9

High levels of oxygen

Question 10

What is hypersensitivity pneumonitis

Answer 10

A cell mediated immune reaction to inhaled agents

Question 11

Hypersensitivity pneumonitis will cause a reaction after?

Answer 11

Previously being exposed to an irritant, the patient will react on reexposure

Question 12

Symptoms of hypersensitivity pneumonitis

Answer 12

Dyspnea 
Chest pain
Fever
Chills
Malaise 
Productive cough

Question 13

Common antigens that cause hypersensitivity pneumonitis include

Answer 13

Bacteria-mushroom compost, mouldy hay, heated water reservoirs
Fungi-mouldy hay, barley, cheese, water, damp wood
Chemicals-paint, plastic, resin

Question 14

Treatment for hypersensitivity pneumonitis

Answer 14

Avoiding triggers

Corticosteroids

Question 15

What are the three most common occupational diseases

Answer 15

Asbestosis
Chronic silicosis
Coal workers pneumoconiosis

Question 16

What would you expect on a chest X-ray of a patient with asbestosis

Answer 16

Plaques
Fibrosis
Effusions
Atelectasis 
Parenchyma scarring

Question 17

What increases risk of lung cancer synergistically

Answer 17

Asbestos exposure and cigarette smoking

Question 18

Symptoms of benign asbestos pleural effusions

Answer 18

Chest pain, fever and dyspnea

Question 19

Treatment for benign asbestos pleural effusions

Answer 19

Draining the effusion to reduce symptoms

Question 20

Treatment for asbestosis

Answer 20

Provide supportive care as patients are typically too old for lung transplant

Question 21

Jobs that have high risk of asbestos exposure

Answer 21

Ship building and insulation work

Question 22

Occupations that have exposure to silica

Answer 22

Mining
Tunneling
Sandblasting
Foundry work

Question 23

Chest X-ray in silicosis will present as

Answer 23

Upper lung abnormalities with small nodular opacities in central lung

Question 24

What would pft findings be in chronic silicosis

Answer 24

Mixed obstructive and restrictive with reduced dlco

Question 25

Silicosis increases risk of

Answer 25

Lung cancer and active tb

Question 26

How does coal workers pneumoconiosis develop

Answer 26

Chronic inhalation of coal dust

Question 27

How are exacerbation of silicosis and pneumococcus treated

Answer 27

Antibiotics and corticosteroids

Question 28

What connective tissue disorders have ild as a known complication

Answer 28

Scleroderma
Rheumatoid arthritis
Sjögren’s syndrome
Systemic lupus

Question 29

Symptoms of connective tissue disease with pulmonary involvement

Answer 29

Dyspnea

Cough

Question 30

Breath sounds with connective tissue it’s ease and ild

Answer 30

Wheezing, crackles or pleural rub

Question 31

What is the most common ild

Answer 31

Sarcoidosis

Question 32

Granulomas form in ?

Answer 32

Sarcoidosis

Question 33

What increases risk of ipf

Answer 33

Exposure to metal or farming dust

Smoking

Question 34

Ipf patients typically die within

Answer 34

4 years of diagnosis