Drug-Induced and Other Lung Diseases

Question 1

Chemotherapeutic agents that cause pneumonitis

Answer 1

BCNU, Bleomycin, Busulfan, Cyclophosphamide, Methotrexate, Mitomycin C, Taxol

Question 2

Non-Chemotherapeutic agents that cause pneumonitis

Answer 2

Amiodarone, Cocaine/heroin, Interferon alpha, Nitrofurantoin, Statins, Immunotherapeutics

Question 3

Chemotherapeutic agents that cause non-cardiogenic pulmonary edema

Answer 3

Azathioprine, cytosine, arabinoside, gemcitabine, IL-2, Methotrexate, Mitomycin, Retinoic Acid

Question 4

Non-chemotherapeutic agents that cause non-cardiogenic pulmonary edema

Answer 4

Amiodarone, ASA/NSAIDs, Cocaine/heroin, Sulfasalazine, Tocolytics

Question 5

Antibody positive in drug induced lupus

Answer 5

Anti-histone

Question 6

5 agents that account for 90% or more of drug induced lupus

Answer 6

Hydralazine, Isoniazide, Penicillamine, Procainamide, Quinidine

Question 7

4 pulmonary syndromes associated with sickle-cell disease

Answer 7

Acute Chest Syndrome, Fat embolism syndrome, Chronic restrictive lung disease, Pulmonary hypertension

Question 8

Key features of fat embolization syndrome

Answer 8

Common postpartum, Multilobar or ARDS pattern, Neurologic features and renal failure, Petechiae, Fat globules in sputum and urine, positive bone scans

Question 9

Treatment of sickle-cell patients at high risk for PAH

Answer 9

Hydroxyurea (raises HgF), Transfusion if not responsive. If PE, lifelong anticoagulation as long as no contraindication. Trial of prostacyclin or ERA, but do not use PDE-5 inhibitor as first line.

Question 10

Triad of findings in hepatopulmonary syndrome

Answer 10

Liver disease, hypoxemia, intrapulmonary vascular dilations

Question 11

Pathophysiology of hepatopulmonary syndrome

Answer 11

pleural and spider nevi with portopulmonary anastamoses leads to a V/Q mismatch

Question 12

Diagnostic criteria for hepatopulmonary syndrome

Answer 12

Liver disease, A-a DO2 >15, Vascular dilation and shunt as evidenced by positive echo bubble study or radioactive albumin appears in brain after injection

Question 13

Treatment for hepatopulmonary syndrome

Answer 13

Oxygen as no medical treatment as been shown to be effective. Transplant is effective.

Question 14

PaO2 value that counts for MELD exception for liver transplant in hepatopulmonary syndrome

Answer 14

< 60

Question 15

Criteria for diagnosing portopulmonary HTN

Answer 15

portal hypertension, RHC measured PA pressure mean > 20, PVR > 240 dynes.s.cm, PAWP < 15

Question 16

Portopulmonary HTN falls under what WHO class of PHTN

Answer 16

Class 1 (1.4.3)

Question 17

Cause of hepatic hydrothorax

Answer 17

Defects in the diaphragm causing pleural effusions

Question 18

Pulmonary lymphoma associated with HHV8

Answer 18

Primary effusion lymphoma (liquid lymphoma)