Eosinophilic Lung Disease

Question 1

Eosinophil granules contents

Answer 1

Major Basic protein (MBP), Eosinophilic cationic protein, Eosinophil derived neurotoxin, Charcot-Leyden crystal protein

Question 2

Cytokines that stimulate growth, differentiation, and production of eosinophils

Answer 2

IL-5, IL-3, GM-CSF

Question 3

Cytokine specific for eosinophils

Answer 3

IL-5

Question 4

Allergic Bronchopulmonary Mycosis also known as

Answer 4

Allergic Bronchopulmonary Aspergillosis

Question 5

2 diseases that have high risk of ABPA

Answer 5

Asthmatics and Cystic Fibrosis

Question 6

Stage I ABPA characteristics

Answer 6

Acute, elevated IgE, Ashtma, Eosinophilia, Opacities, Precipitating antibody

Question 7

Stage II ABPA characteristics

Answer 7

Remission, symptom resolution, reduced IgE

Question 8

Stage III ABPA characteristics

Answer 8

Exacerbation, increased IgE and symptom recurrence

Question 9

Stage IV ABPA characteristics

Answer 9

Steroid dependent asthma, elevated IgE

Question 10

Stage V ABPA characteristics

Answer 10

Fibrotic lung disease

Question 11

ABPA radiographic features

Answer 11

Transient opacities, upper lobe predominant, Finger in glove, Mucoid impaction, Proximal/central bronchiectasis

Question 12

ABPA pathology

Answer 12

Mucoid Impaction, bronchocentric inflammation with eosinophils, lymphocytes, and plasma cells

Question 13

ABPA treatment

Answer 13

Steroids, itraconazole, standard asthma treatment, limited evidence for omalizumab

Question 14

Loeffler syndrome definition

Answer 14

Simple pulmonary eosinophilia

Question 15

Causes of loeffler syndrome

Answer 15

Parasites, drugs, idiopathic

Question 16

CXR findings with loeffler syndrome

Answer 16

Fleeting opacities

Question 17

Treatment loeffler syndrome

Answer 17

Self limited, rarely needs steroids

Question 18

Paragonimiasis definition

Answer 18

Eosinophilic pleural effusion

Question 19

Tropical pulmonary eosinophilia cause

Answer 19

Wuchereria bancrofti in India, Africa, and SE Asia

Question 20

Symptoms of Tropical pulmonary eosinophilia

Answer 20

NOCTURNAL COUGH, fevers, weight loss, malaise, dyspnea, wheezing, and chest pain

Question 21

Treatment of Tropical Pulmonary Eosinophilia

Answer 21

Diethylcarbamazine

Question 22

Strongyloides cause

Answer 22

Autoinfection in an immunocompromised host

Question 23

Symptoms of strongyloides

Answer 23

Cough, wheezing, and hemoptysis

Question 24

Lab and radiologic findings of strongyloides

Answer 24

CXR with ARDS, peripheral eosinophilia

Question 25

Diagnosis of strongyloides

Answer 25

BAL and TBBx

Question 26

Treatment of Strongyloides

Answer 26

Thiabendazole or ivermectin

Question 27

Medications that cause eosinophilia

Answer 27

Daptomycin, ASA, SSRIs

Question 28

What eosinophilic lung disease DOES NOT have peripheral eosinophilia

Answer 28

Acute eosinophilia pneumonia

Question 29

Associations with acute eosinophilic pneumonia

Answer 29

Healthy, young people with a recent onset of smoking cessation, BAL eosinophilia >25%

Question 30

Characteristics of chronic eosinophilic pneumonia

Answer 30

Middle age women non-smokers, Asthma, peripheral eosinophilia > 30%

Question 31

Radiographs for chronic eosinophilic pneumonia

Answer 31

Photonegative pulmonary edema, non-resolving pneumonia

Question 32

Idiopathic hypereosinophilic syndrome classic findings

Answer 32

Young middle aged males with eosinophilia > 1500 for > 6 months or 2 exams > 1 month apart

Question 33

Treatment of idiopathic hypereosinophilic syndrome

Answer 33

Corticosteroids, IFN-alpha, chemotherapy, hydroxyurea, imatinib, mepolizumab

Question 34

3 phases of churg strauss

Answer 34

Asthmatic (prodromal 8-10 years), eosinophilic (peripheral and tissue eosinophilia), Vasculitis (necrotizing vasculitis and granulomas)

Question 35

Diagnostic criteria of churg strauss

Answer 35

Asthma, mononeuritis multiplex, sinus disease, peripheral eosinophilia > 1500 or 10%, Migratory pulmonary opacities, and extravascular eosinophils on biopsy; MUST HAVE 4 of the 6

Question 36

Diagnostic strategy for churg strauss

Answer 36

Leukotriene receptor antagonists to decrease steroid use to allow for eosinophilia

Question 37

Treatmetn of churg strauss

Answer 37

Steroids, azathioprine, MTX, mepolizumab

Question 38

Assessment for churg strauss

Answer 38

Five factors score (0-2), age > 65, +cardiac, +renal, +GI, absence of ENT