Instastitial Lung Disease

Question 1

Pathophysiology

Answer 1

Respiratory disease causing diffuse fibrosis and scarring to lung parenchyma.

Question 2

Causes

Answer 2

1. UIP
2. NSIP
3. Extrinsic Allergic Alveolitis
4. Sarcoidois

Question 3

UIP

Answer 3

Idiopathic

causes: Course crackles, Stony dull percussion, clubbing

Question 4

Extrinic Allergic Alveolitis Pathophysiology

Answer 4

immune sensitisation to organic antigen

Question 5

Extrinsic Allergic Alveolitis causes

Answer 5

Asbestiosis
Pneumoconiosis
Silicosis
Amiodarone
Methotrexate
Bleomycin
Nitrofurantoin
RA/ SLE
HIV

Question 6

Extrinsic Allergic alveolitis types

Answer 6

1. Acute- Short exposure (3-8hrs) , Symptoms 1-3 days, Reversible, Recurs
2. Chronic - Long exposure (months - Yrs) , Symptoms Long term, Irreversible

Question 7

Sarcoidosis pathophysiology

Answer 7

Immune condition effecting multisystem includes: Skin, Eyes, Resp, Brain

Question 8

Sarcoidosis symptoms

Answer 8

Erythema nodosum
Cough, SOB
Headache
Visual changes
Fever
Wt loss
Fatigue

Question 9

Sacrcoidosis Investigations

Answer 9

CXR
Elevated ACE
Elevated serum/ Urine Ca
RF to rule out RA which also causes ILD
ANA to rule out SLE which aslo causes ILD
Broncoalveolar lavage elevated T Cells
Biopsy: Non caseating granuloma

Question 10

Sarcoidosis CXR Signs

Answer 10

Bilateral Hilar Lymphadenopathy

Question 11

Sarcoidosis treatment

Answer 11

50% self resolving (months- 1 year)
50% Require steroid therapy

Question 12

ILD Imaging Signs

Answer 12

CXR - Kerley lines
CXR - Pleural plaques (asbestosis)
CT - Honeycombing