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Yr 3 Medicine Resp > Insterstitial Lung Disease > Flashcards

Insterstitial Lung Disease Flashcards

1
Q

What does interstitial lung disease affect?

A

The lung parenchyma

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2
Q

Name some types of ILD

A

Usual Interstitial Pneumonia (UIP)
non specific interstitial pneumonia (NSIP)
Extrinsic allergic alveolitis
Sarcoidsosis

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3
Q

What features of the history are particularly important regarding ILD?

A

Occupational and environmental history

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4
Q

How would ILD present on a peak flow test?

A

Restrictive

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5
Q

What investigations should be performed for new diagnoses of ILD?

A

ANA, ENA, RhF, ANCA, Anti-GBM, ACE, IgG to serum precipitins

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6
Q

What is the most common type of pulmonary fibrosis?

A

Usual interstitial pneumonia (UIP)

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7
Q

What is the usual cause of UIP?

A

Idiopathic

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8
Q

What are the classical findings in UIP?

A

Clubbing, reduced chest expansion
On ausculation, fine inspiratory reps like velcro usually heard in basal and auxiliary areas
May have features of pulmonary hypertension

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9
Q

Which responds better to steroids UIP or NSIP?

A

NSIP

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10
Q

What is another term for allergic alveoli’s?

A

Hypersensitivity pneumonitis

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11
Q

What happens in extrinsic allergic alveolitis?

A

Inhalation of organic antigen to which the individual has been sensitised

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12
Q

How may extrinsic allergic alveoli’s be triggered?

A

Exposure to birds

Drugs: amiodarone, nitrofurantoin

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13
Q

How can extrinsic allergic alveoli’s present?

A

Acute or chronic

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14
Q

Discuss ACUTE extrinsic allergic alveolitis

A

Occurs a short period from exposure normal 4-8hrs
Usually reversible
Spontaneously setles in 1-3 days
Can reoccur

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15
Q

Discuss CHRONIC extrinsic allergic alveolitis

A

Chronic exposure over months to years

Less reversible

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16
Q

What is sarcoidosis?

A

Multi system inflammatory condition of unknown cause

17
Q

What is the relevant histology of sarcoidosis?

A

Non caseating granuloma

18
Q

What is the prognosis for sarcoidosis?

A

50% get spontaneous remission, others get progressive disease

19
Q

What investigations should be undertaken for a patient with sarcoidosis?

A

PFTs (obstructive until) fibrosis
CXR -4 stages
Bloods: renal function, ACE, calcium
Urinary calcium
Cardiac involvement: ECG, 24hr tape, ECHO, cardiac MRI
CT/MRI head may get headaches due to neurosarcoid

20
Q

What is important in ILD treatment?

A

Detailed history to see if there is any triggers that could be removed

21
Q

Discuss some principles in ILD treatment

A 
Remove occupational exposures
Avoid drugs associated
Stop smoking 
N-acetylecysteine, immunosupressant, pirfenidone
Transplant 
Treat infections 
Oxygen 
MDT, palliative care

Yr 3 Medicine Resp (13 decks)

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