Fibrotic lung disease Flashcards
What drug is known to cause lung fibrosis?
amiodarone
Which cytotoxic agents can cause lung fibrosis?
busulphan, bleomycin
What anti-rheumatoid drugs are associated with lung fibrosis?
methotrexate, sulfasalazine
Which antibiotic is known to cause lung fibrosis?
nitrofurantoin
What type of drugs derived from ergot can cause lung fibrosis?
dopamine receptor agonists (bromocriptine, cabergoline, pergolide)
What is idiopathic pulmonary fibrosis (IPF)?
IPF is a chronic lung condition characterised by progressive fibrosis of the interstitium of the lungs. The term IPF is reserved when no underlying cause exists.
What age group is typically affected by IPF?
IPF is typically seen in patients aged 50-70 years and is twice as common in men.
What are the key features of IPF?
Key features include progressive exertional dyspnoea, bibasal fine end-inspiratory crepitations on auscultation, dry cough, and clubbing.
How is IPF diagnosed?
Diagnosis involves spirometry showing a restrictive picture, impaired gas exchange with reduced transfer factor, and imaging revealing bilateral interstitial shadowing.
What imaging is preferred for diagnosing IPF?
High-resolution CT scanning is the investigation of choice for diagnosing IPF.
What are the common serological findings in IPF?
ANA is positive in 30% of cases and rheumatoid factor is positive in 10%, but low titres do not necessarily indicate secondary fibrosis.
What is the management for IPF?
Management includes pulmonary rehabilitation, potential use of pirfenidone, supplementary oxygen, and possibly lung transplant.
What is the prognosis for patients with IPF?
The prognosis is poor, with an average life expectancy of around 3-4 years.
Idiopathic pumonary fibrosis
What is lung fibrosis?
Lung fibrosis is a condition characterized by scarring and thickening of the lung tissue.
Why is it important to differentiate between upper and lower zone fibrosis?
Differentiating between conditions causing predominantly upper or lower zone fibrosis is crucial for diagnosis.
What are the common causes of lower zone fibrosis?
Common causes include idiopathic pulmonary fibrosis and drugs like amiodarone, bleomycin, and methotrexate.
What conditions predominantly affect the upper zones?
Conditions include hypersensitivity pneumonitis, coal worker’s pneumoconiosis, silicosis, sarcoidosis, ankylosing spondylitis, histiocytosis, tuberculosis, and radiation-induced pulmonary fibrosis.
What is the acronym for causes of upper zone fibrosis?
The acronym is CHARTS: C - Coal worker’s pneumoconiosis, H - Histiocytosis/hypersensitivity pneumonitis, A - Ankylosing spondylitis, R - Radiation, T - Tuberculosis, S - Silicosis/sarcoidosis.
What is a notable feature of radiation-induced pulmonary fibrosis?
It may develop following radiotherapy for breast or lung cancer, typically seen between 6 and 12 months after treatment.
