ILD

Question 1

typical radiographic presentation of IPF

Answer 1

UIP

Question 2

4 criteria for UIP pattern

Answer 2

• predominantly subpleural and basilar distribution
• reticular appearance
• honeycombing
• no features to suggest another etiology

Question 3

How is a possible UIP pattern different than a (definite) UIP pattern?

Answer 3

absence of honeycombing

Question 4

Define Löfgren syndrome (4 signs)

Answer 4

Fever, e. nodosum, arthralgias, b/l hilar lymphadenopathy

Question 5

Löfgren syndrome is a presentation of what ILD?

Answer 5

Sarcoidosis

Question 6

What kinds of infections typically cause granulomas?

Answer 6

Mycobacterial and fungal

Question 7

Typical findings on BAL in sarcoidosis

Answer 7

Lymphocytic predominance (>15%), CD4/CD8 >4

Question 8

Sarcoidosis (pulmonary) stage 0

Answer 8

No lung involvement

Question 9

Sarcoidosis (pulmonary) stage I

Answer 9

B/l hilar adenopathy without parenchymal involvement

Question 10

Sarcoidosis (pulmonary) stage II

Answer 10

B/L hilar adenopathy WITH parenchymal involvement

Question 11

Sarcoidosis (pulmonary) stage III

Answer 11

Parenchymal involvement without hilar adenopathy

Question 12

Sarcoidosis (pulmonary) stage IV

Answer 12

Progressive fibrosis ± cavity/cysts

Question 13

Where do fibrosis and honeycombing predominate in sarcoidosis?

Answer 13

Upper lungs

Question 14

Electrolyte abnormality in sarcoidosis

Answer 14

Hypercalcemia

Question 15

Pathogenesis of hypercalcemia in sarcoid

Answer 15

Macrophages convert Vit D to calcitriol

Question 16

Medication for cough in sarcoidosis stage I or mild stage II

Answer 16

Inhaled corticosteroid

Question 17

Rx for initial course of steroids in sarcoidosis

Answer 17

20-40 mg prednisone x 4-6 weeks

Question 18

Duration of steroid taper in sarcoidosis

Answer 18

6-12 MONTHS

Question 19

Preferred steroid-sparing agent for sarcoidosis

Answer 19

MTX