Interstit Lung Dz

Question 1

ILD is?

Answer 1

pulmonary fibrosis
non-malig
non-infectious

Question 2

ILD affects lung how? (3)

Answer 2

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

Question 3

ILD a/w?

Answer 3

other dz
exposures
drugs

Question 4

ILD presentation?

Answer 4

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

Question 5

ILD CXR findings?

Answer 5

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

Question 6

ILD plum fxn tests used to?

Findings?

Answer 6

assess severity

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

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

Question 7

ILD gold stand diagnostic?

Answer 7

lung bx

Question 8

ILD complications?

Answer 8

pulmonary HTN -> HF
pneumothorax
↑ CA risk

Question 9

ILD classifications: to known cause?

Answer 9

occupational/environmental
drugs/poison
infection

Question 10

ILD class: to known diseases?

Answer 10

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

Question 11

Asbestosis signs?

Answer 11

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

Question 12

Asbestosis diagnostics?

Answer 12

CXR = low lung opacity, pleural plaques

Bx = definitive diag but not (U) indicated

PFT = restrictive

Question 13

Asbestosis mgmt?

Answer 13

pulmon referral
no effective tx
stop progression

Question 14

Silicosis characterized by?

Answer 14

fibronodular lung dz

Question 15

Silicosis Simple?

Answer 15

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

Question 16

Silicosis Complicated?

Answer 16

> 20 yr exposure
progressive forever

tachy
prolonged expiration
rhonci, rales, wheeze

Question 17

Silicosis Complicated:
CXR?

PFT?

Mgmt?

Answer 17

large opacity

restrictive

refer
no tx

Question 18

Sarcoidosis is?

Epidemiology?

Answer 18

multisystem inflamm,
noncaseating granulomas,

blacks»whites
20-40 yo
F>M

Question 19

Sarcoidosis presentation?

Answer 19

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

Question 20

Sarcoidosis CXR staging?

Answer 20

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

Question 21

Sarcoidosis PFT?

Answer 21

Isolated DLCO

Restrictive

Question 22

Sarcoidosis Labs?

Answer 22

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

Question 23

Sarcoidosis diagnosis U requires?

Answer 23

bx

Question 24

Sarcoidosis mgmt?

Answer 24

refer
(U) sxs tx
corticsteroids
monitor

Question 25

Wegener’s Granulomatosis?

Answer 25

Systemic VASCULITIS, immune-mediated

Up/Low resp necrotizing granulomas

(U) have GLOMERULONEPHRITIS

high morbidity

Question 26

Wegener’s Granulomatosis epidemiology?

Answer 26

M=W
40-50s
Whites

Question 27

Wegener’s Granulomatosis presentation?

Answer 27

Up airway sxs:
rhinorr, oral/nasal ulcers

Low airway sxs:
dysp, cough, pleur paink, hemopt

PFT:
restr/obstr
↓DLCO
↓ lung vol

Question 28

Wegener’s Granulomatosis findings:

CXR?

CT?

Answer 28

CXR = abn but variable

CT = bv feeding nodules/cavities,
irreg stellate periph pulm aa

Question 29

Wegener’s Granulomatosis lab findings?

Answer 29

+ ANCA
↑ ESR
↑ BUN/Cr
leuko/thrombocytosis

Question 30

Wegener’s Granulomatosis diagnosis?

Answer 30

clinical/histopath

Question 31

Wegener’s Granulomatosis tx?

Answer 31

refer rhemuatology

cyclophos/glucocort

Question 32

Idiopathic Pulmonary Fibrosis (IPF) diagnosed how?

Epidem?

Answer 32

r/o other ILD

M smokers
60s

Question 33

IPF presentation?

Answer 33

inflam and fibrosis of parenchyma

DOE
dry cough
inspr crackels
clubbing

Question 34

IPF CXR findings?

Answer 34

bilat diffuse reticular/nodular infiltrates

periphery/bases

Question 35

IPF PFT findings?

Answer 35

restrictive

↓ TLC

Question 36

IPF diagnosis?

Answer 36

bx

Question 37

IPF mgmt?

Answer 37

refer pulmo

eval for transplant