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Respiratory > ILD > Flashcards

ILD Flashcards

1
Q

What is ILD?

A

Interstitial lung disease
Causes inflammation and fibrosis of lung parenchyma

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2
Q

What are the presenting features of ILD? (3)

A

Sob on exertion
Dry cough
Fatigue

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3
Q

What are the typical signs of idiopathic pulmonary fibrosis? (2)

A

Bibasal fine end inspiratory crackles
Finger clubbing

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4
Q

What is used in diagnosis of ILD? (3)

A

Clinical features
High resolution ct scan - ground glass
Spirometry

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5
Q

What Spirometry pattern is seen in ILD?

A

Normal or restrictive
>0.7

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6
Q

What is the management of ILD? (7)

A

• Remove or treat the underlying cause
• Home oxygen where there is hypoxia
• Stop smoking
• Physiotherapy and pulmonary rehabilitation
• Pneumococcal and flu vaccine
• Advanced care planning and palliative care where appropriate
• Lung transplant is an option, but the risks and benefits need careful consideration

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7
Q

What is the presentation of idiopathic pulmonary fibrosis? (2)

A

Insidious sob
Dry cough over 3 months

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8
Q

What is the prognosis of idiopathic pulmonary fibrosis?

A

2-5 years

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9
Q

What 2 medications can slow progression of idiopathic pulmonary fibrosis?

A

• Pirfenidone reduces fibrosis and inflammation through various mechanisms
• Nintedanib reduces fibrosis and inflammation by inhibiting tyrosine kinase

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10
Q

How does nintedanib slow fibrosis?

A

Inhibits tyrosine kinase

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11
Q

What drugs can cause pulmonary fibrosis? (4)

A

Amiodarone
Cyclophosphamide
Methotrexate
Nitrofurantoin

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12
Q

What conditions can cause pulmonary fibrosis? (5)

A

○ Alpha-1 antitrypsin deficiency
○ Rheumatoid arthritis
○ Systemic lupus erythematosus (SLE)
○ Systemic sclerosis
○ Sarcoidosis

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13
Q

What test is performed to diagnose hypersensitivity pneumonitis? What is a positive result?

A

Broncheoalveolar lavage
Raised lymphocytes

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14
Q

What is hypersensitivity pneumonitis?

A

involves type III and type IV hypersensitivity reaction to an environmental allergen. Inhalation of allergens in patients sensitised to that allergen causes an immune response, leading to inflammation and damage to the lung tissue.

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15
Q

What is the management of hypersensitivity pneumonitis? (3)

A

Removing allergen
Oxygen
Steroid

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16
Q

What is cryptogenic organising pneumonia?

A

It involves a focal area of inflammation of the lung tissue. It can be idiopathic or triggered by infection, inflammatory disorders, medications, radiation, environmental toxins, or allergens.

17
Q

What is the presentation of cryptogenic organising pneumonia? (5)

A

Similar to infectious pneumonia

Sob
Cough
Fever
Lethargy
Inspiratory crackles

18
Q

What is the definitive investigation in cryptogenic organising pneumonia?

A

Lung biopsy

19
Q

What is the treatment of cryptogenic organising pneumonia?

A

Systemic corticosteroids

20
Q

What can asbestos inhalation cause? (4)

A

Lung fibrosis (asbestosis)
Pleural thickening and pleural plaques
Adenocarcinoma
Mesothelioma

Respiratory (18 decks)

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