ILD

Question 1

What are examples of ILD associated with CT disease?

Answer 1

Systemic sclerosis, RA, dermatomyositis/polymyositis

Question 2

What is systemic sclerosis?

Answer 2

MC CT disease associated with ILD; 50% to have diffuse pathology, 30% have limited involvement

Question 3

What is the relationship between ILD and rheumatoid arthritis?

Answer 3

RA-ILD more common in males than females (in general RA affects F>M)

Question 4

What is the relationship between ILD and dermatomyositis/polymyositis?

Answer 4

ILD associated with 45% of cases + anti-synthetase Abs; anti-synthetase syndrome (myositis, fever, Raynaud’s, mechanic hands, arthritis, and ILD)

Question 5

What are examples of pneumoconiosis?

Answer 5

Silicosis, asbestosis, coal worker disease, berylliosis

Question 6

What is silicosis?

Answer 6

Associated with miners, stone cutters, sand blasting and quarry workers; long exposure can result in simple silicosis (radiographs show nodular lung disease and calcified hilar LNs)

Question 7

What is complicated silicosis?

Answer 7

Progressive disease; radiographs show large nodules (>1cm) with extensive fibrosis

Question 8

Pts with silicosis have increased risk of what?

Answer 8

infection especially Tb

Question 9

What is asbestosis?

Answer 9

Associated with construction workers, insulation, demolition, and automobile workers; radiographs show multiple nodular opacities, pleural effusions, pleural fibrosis, may see blurring of diaphragm/cardiac silhouette

Question 10

What is asbestos?

Answer 10

Fibrous material made of a composite of inorganic minerals

Question 11

What are pts with asbestosis at increased risk for?

Answer 11

Increased risk of malignant mesothelioma and lung cancer (asbestosis and cigarette smoking has a synergistic effect on lung cancer rates)

Question 12

What is coal workers pneumoconiosis (CWP)?

Answer 12

Inhalation of coal dust which has high levels of silica; affects miners

Question 13

What is simple CWP?

Answer 13

Asymptomatic; radiology shows small nodules (<1cm) found most often at the apex

Question 14

What is complicated CWP?

Answer 14

Symptomatic (cough, dyspnea, sputum production); PFTs show restrictive pattern; radiology shows large nodules (>1cm), patchy infiltrates at the bases and fibrosis

Question 15

What is berylliosis?

Answer 15

Exposure to beryllium due to an occupation in manufacturing of alloys and electronic devices; increased risk of lung cancer; tx = steroids and removal of beryllium environment

Question 16

What is acute berylliosis?

Answer 16

Rare, similar reaction to hypersensitivity pneumonitis, thought to be an immunologic response

Question 17

What is chronic berylliosis?

Answer 17

Insidious onset, thought to be from cumulative exposure/inhalation of beryllium; radiographs show hilar LAD, diffuse infiltrates similar to sarcoidosis; PFTs show restrictive pattern, rare occasions cause obstruction due to LAD enlargement