Fibrosis

Question 1

Give 4 examples of extrinsic allergic alveolitis

Answer 1

Bird fanciers lung: avian proteins
Farmers lung: spores of saccharopolyspora rectivirgula
Malt workers lung: aspergillus clavatus
Mushroom workers lung: thermophillic actinomycetes

Question 2

What’s the choice of imaging for idiopathic pulmonary fibrosis and what is seen?

Answer 2

High resolution CT- honeycombing bases>apices

Question 3

What is pulmonary histiocytosis?

Answer 3

Eosinophilic granulomas of the lung. Causes fibrosis or cysts in the upper zones. Lung volumes are preserved.

Associated with bone cysts and diabetes insipidus

Question 4

What features would be present on examination of someone with pulmonary fibrosis?

Answer 4

Progressive exertional dyspnoea
Bibasal fine crackles on inspiration
Dry cough
Clubbing

Question 5

What’s the management for pulmonary fibrosis?

Answer 5

Pulmonary rehabilitation

Not many medicines: pirfenidone (an anti fibrotic agent) may be useful in some patients.

Supplementary oxygen therapy and eventually a lung transplant.

Question 6

What is seen on imaging of silicosis (pulmonary fibrosis)?

Answer 6

Egg-shell calcification of the hilar lymphnodes.

Upper zone fibrosis

Question 7

Radiological findings in silicosis?

Answer 7

Numberous small opacities in the upper zones and hilar lymphadenopathy
Egg shell calcification.