Diffuse parenchymal disease

Question 1

What are interstitial lung disorders?

Answer 1

Broad category of diseases that cause diffuse alveolar inflammation. can be idiopathic, drug caused or secondary to autoimmune disease, environmental or occupational triggers.

Question 2

What are 3/5 drug causes for pulmonary fibrosis?

Answer 2

• amiodarone
• methotrexate
• nitrofurantoin
• cyclophosphamide
• bleomycin

Question 3

What occupational exposure can cause pulmonary fibrosis?

Answer 3

• asbestosis

- silicosis

Question 4

what diseases can cause pulmonary fibrosis?

Answer 4

• Idiopathic pulmonary fibrosis is the most common cause
• RA
• sarcoidosis
• hypersensitivity pneumonitis
• Non-specific interstitial pneumonia

Question 5

what are the clinical features of interstitial lung disease?

Answer 5

• exertional dyspnoea - progresses to at rest
• chronic non-productive cough
• bibasal fine inspiratory crackles
• fatigue

Question 6

What investigations would you do for suspected interstitial lung disease?

Answer 6

• spirometry - restrictive pattern - FEV low, FVC low, normal FVC/FEV1 ratio
• ABG - PaO2 maybe increased
• CXR + CT - fibrosis

Question 7

What 2 drugs can be used in treatment of IPF to prolong life?

Answer 7

perfenidone & nintedanib

Question 8

What other treatments may be used in interstitial lung disease?

Answer 8

steroids
O2
avoid triggers

Question 9

define sarcoidosis.

Answer 9

A multisystem disease of unknown aetiology, primarily lung and lymph. Granulomatous histology.

Question 10

Typical findings on CX/CT?

Answer 10

bilateral hilar lymphadenopathy