Interstit Lung Dz Flashcards

1
Q

ILD is?

A

pulmonary fibrosis
non-malig
non-infectious

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2
Q

ILD affects lung how? (3)

A

1) parenchyma damage
2) alveoli wall inflamm
3) fibrosis (scarring) in interstitium -> stiff lungs

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3
Q

ILD a/w?

A

other dz
exposures
drugs

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4
Q

ILD presentation?

A
Progressive DOE
Dry cough
Crackles
Insp squeaks
Cor pumonale (R heart enlarg)
Cyanosis/clubbing (late)
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5
Q

ILD CXR findings?

A

ground-glass
reticular “netlike” bilat opacity
honeycombing (poor prog)

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6
Q

ILD plum fxn tests used to?

Findings?

A

assess severity

(U) restrictive defect:
hypoxemia
↓ diffusion capacity of CarbonMono (DLCO)

↓ TLC,
↓ FEV and FVC, but proportional so ratio is normal,

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7
Q

ILD gold stand diagnostic?

A

lung bx

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8
Q

ILD complications?

A

pulmonary HTN -> HF
pneumothorax
↑ CA risk

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9
Q

ILD classifications: to known cause?

A

occupational/environmental
drugs/poison
infection

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10
Q

ILD class: to known diseases?

A

1) sarcoidosis
2) CT/autoimm: sclelroderma, SLE, RA, polymyositis, vasculitis
3) Pneumoconiosis (inhal of particles)

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11
Q

Asbestosis signs?

A
nothing specific:
insidious onset of dyspnea
dry cough
insp crackles
clubbing
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12
Q

Asbestosis diagnostics?

A

CXR = low lung opacity, pleural plaques

Bx = definitive diag but not (U) indicated

PFT = restrictive

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13
Q

Asbestosis mgmt?

A

pulmon referral
no effective tx
stop progression

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14
Q

Silicosis characterized by?

A

fibronodular lung dz

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15
Q

Silicosis Simple?

A

10-12 yr exposure,
Φ progression w/ exposure elimination,
hilar node calcification (eggshell),
round opacities

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16
Q

Silicosis Complicated?

A

> 20 yr exposure
progressive forever

tachy
prolonged expiration
rhonci, rales, wheeze

17
Q

Silicosis Complicated:
CXR?

PFT?

Mgmt?

A

large opacity

restrictive

refer
no tx

18
Q

Sarcoidosis is?

Epidemiology?

A

multisystem inflamm,
noncaseating granulomas,

blacks»whites
20-40 yo
F>M

19
Q

Sarcoidosis presentation?

A

fever, arthralgias
DOE, cough, chest pain
CN palsies
Erythema nodusum

20
Q

Sarcoidosis CXR staging?

A

0: normal
1: hilar adenopathy
2: hilar adenopathy + diffuse infiltrates
3: diffuse parenchymal infiltarates
4: pulm fibrosis

21
Q

Sarcoidosis PFT?

A

Isolated DLCO

Restrictive

22
Q

Sarcoidosis Labs?

A

↑ SERUM ACE
hyper Ca2+
↑ ESR (inflamm)
↑ serum protein

23
Q

Sarcoidosis diagnosis U requires?

24
Q

Sarcoidosis mgmt?

A

refer
(U) sxs tx
corticsteroids
monitor

25
Wegener's Granulomatosis?
Systemic VASCULITIS, immune-mediated Up/Low resp necrotizing granulomas (U) have GLOMERULONEPHRITIS high morbidity
26
Wegener's Granulomatosis epidemiology?
M=W 40-50s Whites
27
Wegener's Granulomatosis presentation?
Up airway sxs: rhinorr, oral/nasal ulcers Low airway sxs: dysp, cough, pleur paink, hemopt PFT: restr/obstr ↓DLCO ↓ lung vol
28
Wegener's Granulomatosis findings: CXR? CT?
CXR = abn but variable CT = bv feeding nodules/cavities, irreg stellate periph pulm aa
29
Wegener's Granulomatosis lab findings?
+ ANCA ↑ ESR ↑ BUN/Cr leuko/thrombocytosis
30
Wegener's Granulomatosis diagnosis?
clinical/histopath
31
Wegener's Granulomatosis tx?
refer rhemuatology | cyclophos/glucocort
32
Idiopathic Pulmonary Fibrosis (IPF) diagnosed how? Epidem?
r/o other ILD M smokers 60s
33
IPF presentation?
inflam and fibrosis of parenchyma DOE dry cough inspr crackels clubbing
34
IPF CXR findings?
bilat diffuse reticular/nodular infiltrates | periphery/bases
35
IPF PFT findings?
restrictive | ↓ TLC
36
IPF diagnosis?
bx
37
IPF mgmt?
refer pulmo | eval for transplant