Diffuse Parenchymal Lung Diseases

Question 1

BAL alone can diagnose which parenchymal lung diseases?

Answer 1

• Malignancy
• Infection
• PAP
• PLCH
• Exogenous lipoid pneumonia

Question 2

Normal BAL cell counts:

• Lymphocytic?
• Eosinophilic?
• Neutrophilic?

Answer 2

• Lymphocytic >15%
• Eosinophilic >1%
• Neutrophilic >3%

Question 3

Survival for IPF?

Answer 3

Median 3 year survival

Question 4

Genetic predisposition for IPF?

Answer 4

MUC5B, TERT, TOLLIP

Question 5

Which Interstitial Interstitial Pneumonia’s benefit from immunosupressants?

Answer 5

NSIP & COP

Question 6

PFTs in RBILD & DIP?

Answer 6

Mixed obstructive and restrictive

Question 7

Name 5 smoking-associated ILDs.

Answer 7

• RBILD
• DIP
• PLCH
• AEP
• CPFE

Question 8

Most common ILD due to connective tissue disease?

Answer 8

NSIP

-Except Sjogren’s Dz, which causes LIP.

Question 9

Treatment of ILDs due to connective tissue diseases?

Answer 9

Steroids for 3-6 months.

-Except scleroderma, which you treat with MMF and possibly antifibrotics

Question 10

Screening tests after diagnosis of sarcoid is made?

Answer 10

EKG or TTE

Question 11

Lofgren Syndrome components?

Answer 11

• Bilateral hilar LAD
• E. Nodosum
• fever
• arthralgias

Question 12

Mortality from sarcoid due to?

Answer 12

Aspergilloma bleed
cardiac
pulmonary fibrosis

Question 13

Indications for treatment of sarcoidosis?

Answer 13

• Stage II-III w/ moderate-severe PFT changes
• hypercalcemia
• end-organ (cardiac, neurologic, occular)

Question 14

Treatment of sarcoidosis?

Answer 14

Prednisone 20-40mg, taper over 6-12 months.

-Alternative immunosuppressant is MTX