Idiopathic Pulmonary Fibrosis

Question 1

Symptoms of IPF?

Answer 1

exertional dyspnea, dry cough, Malaise, Arthalgia,

Weight Loss

Question 2

Signs of IPF?

Answer 2

Finger clubbing, fine end-inspiratory crepitations, cyanosis

Question 3

Complications of IPF

Answer 3

Increased risk of Lung Ca, and Respiratory Failure

Question 4

Investigations

Answer 4

ABG, CRP, Immunoglobulins, ANA, rheumatoid factor. CXR, CT, Spirometry, BAL, Lung biopsy.

Question 5

Management

Answer 5

Supportive care, Oxygen, pulmonary rehabilitation, opiates, palliative care input.

Question 6

What would ABG show in IPF?

Answer 6

Decreased PaO2 and in severe disease increased PaCO2

Question 7

Describe a typical CXR in IPF?

Answer 7

Reduced Lung volume,
Bilat Lower Zone reticulonodular shadowing,
Honeycombing of the lung,

Question 8

What would Spirometry show in IPF?

Answer 8

Restrictive defect, and decreased DLCO (transfer factor)

Question 9

What are the histological changes observed on biopsy known as?

Answer 9

Usual interstitial Pneumonia

Question 10

What could a typical BAL show in alveolitis?

Answer 10

Alveolitis: Lymphocytes (good response / prognosis), Neutrophils, or Eosinophils (poor response / prognosis)