Interstit Lung Dz Flashcards
ILD is?
pulmonary fibrosis
non-malig
non-infectious
ILD affects lung how? (3)
1) parenchyma damage
2) alveoli wall inflamm
3) fibrosis (scarring) in interstitium -> stiff lungs
ILD a/w?
other dz
exposures
drugs
ILD presentation?
Progressive DOE Dry cough Crackles Insp squeaks Cor pumonale (R heart enlarg) Cyanosis/clubbing (late)
ILD CXR findings?
ground-glass
reticular “netlike” bilat opacity
honeycombing (poor prog)
ILD plum fxn tests used to?
Findings?
assess severity
(U) restrictive defect:
hypoxemia
↓ diffusion capacity of CarbonMono (DLCO)
↓ TLC,
↓ FEV and FVC, but proportional so ratio is normal,
ILD gold stand diagnostic?
lung bx
ILD complications?
pulmonary HTN -> HF
pneumothorax
↑ CA risk
ILD classifications: to known cause?
occupational/environmental
drugs/poison
infection
ILD class: to known diseases?
1) sarcoidosis
2) CT/autoimm: sclelroderma, SLE, RA, polymyositis, vasculitis
3) Pneumoconiosis (inhal of particles)
Asbestosis signs?
nothing specific: insidious onset of dyspnea dry cough insp crackles clubbing
Asbestosis diagnostics?
CXR = low lung opacity, pleural plaques
Bx = definitive diag but not (U) indicated
PFT = restrictive
Asbestosis mgmt?
pulmon referral
no effective tx
stop progression
Silicosis characterized by?
fibronodular lung dz
Silicosis Simple?
10-12 yr exposure,
Φ progression w/ exposure elimination,
hilar node calcification (eggshell),
round opacities
Silicosis Complicated?
> 20 yr exposure
progressive forever
tachy
prolonged expiration
rhonci, rales, wheeze
Silicosis Complicated:
CXR?
PFT?
Mgmt?
large opacity
restrictive
refer
no tx
Sarcoidosis is?
Epidemiology?
multisystem inflamm,
noncaseating granulomas,
blacks»whites
20-40 yo
F>M
Sarcoidosis presentation?
fever, arthralgias
DOE, cough, chest pain
CN palsies
Erythema nodusum
Sarcoidosis CXR staging?
0: normal
1: hilar adenopathy
2: hilar adenopathy + diffuse infiltrates
3: diffuse parenchymal infiltarates
4: pulm fibrosis
Sarcoidosis PFT?
Isolated DLCO
Restrictive
Sarcoidosis Labs?
↑ SERUM ACE
hyper Ca2+
↑ ESR (inflamm)
↑ serum protein
Sarcoidosis diagnosis U requires?
bx
Sarcoidosis mgmt?
refer
(U) sxs tx
corticsteroids
monitor
Wegener’s Granulomatosis?
Systemic VASCULITIS, immune-mediated
Up/Low resp necrotizing granulomas
(U) have GLOMERULONEPHRITIS
high morbidity
Wegener’s Granulomatosis epidemiology?
M=W
40-50s
Whites
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
Wegener’s Granulomatosis findings:
CXR?
CT?
CXR = abn but variable
CT = bv feeding nodules/cavities,
irreg stellate periph pulm aa
Wegener’s Granulomatosis lab findings?
+ ANCA
↑ ESR
↑ BUN/Cr
leuko/thrombocytosis
Wegener’s Granulomatosis diagnosis?
clinical/histopath
Wegener’s Granulomatosis tx?
refer rhemuatology
cyclophos/glucocort
Idiopathic Pulmonary Fibrosis (IPF) diagnosed how?
Epidem?
r/o other ILD
M smokers
60s
IPF presentation?
inflam and fibrosis of parenchyma
DOE
dry cough
inspr crackels
clubbing
IPF CXR findings?
bilat diffuse reticular/nodular infiltrates
periphery/bases
IPF PFT findings?
restrictive
↓ TLC
IPF diagnosis?
bx
IPF mgmt?
refer pulmo
eval for transplant
