Interstitial Lung Disease Flashcards

1
Q

What is Interstitial lung disease

A

Umbrella term for conditions that affect lung parenchyma causing inflammation and fibrosis

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2
Q

What is fibrosis

A

the replacement of normal elastic and functional tissue to scar tissue that is stiff

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3
Q

How is interstitial lung disease diagnosed

A

1- High resolution CT scan of thorax
2- lung biopsy is diagnosis is unclear
3- clinical features

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4
Q

How does interstitial lung disease appear on the HRCT

A

Ground glass appearance

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5
Q

Is the damage in interstitial lung disease reversible

A

No

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6
Q

What are the management options for interstitial lung disease ( Hint: 7 )

A

1- remove or treat underlying cause
2- home oxygen if hypoxic at rest
3- stop smoking
4- physiotherapy and pulmonary rehabilitation
5- pneumococcal and flu vaccine
6- advanced care planning and palliative care if appropriate
7- lung transplant

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7
Q

What is Idiopathic pulmonary fibrosis

A

Condition where there is progressive pulmonary fibrosis with no clear cause.

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8
Q

How does idiopathic pulmonary fibrosis present

A

1- insidious onset of SOB
2- dry cough over 3+ months
3- bibasal fine inspiratory crackles
4- finger clubbing

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9
Q

What is the prognosis of idiopathic pulmonary fibrosis

A

poor prognosis with 2-5 years for life expectancy

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10
Q

What medications are used to slow the progression of idiopathic pulmonary fibrosis and explain their purpose

A

1- Piefenidone : antifibrotic and anti inflammatory

2- Nintedanib : antibody targeting tyrosine kinase

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11
Q

What drugs can cause drug induced pulmonary fibrosis ( Hint : 4 )

A

1- Amiodarone
2- Cyclophosphamide
3- methotrexate
4- Nitrofurantoin

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12
Q

Secondary pulmonary fibrosis can occur secondary to what conditions ( Hint: 4 )

A

1- Alpha-1 antitripsin deficiency
2- Rheumatoid arthritis
3- Systemic lupus erythematosus ( SLE)
4- Systemic sclerosis

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13
Q

What is hypersensitivity pneumonitis

A

A type III hypersensitivity reaction to environment allergen that causes a parenchymal inflammation in patients sensitive to that allergen

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14
Q

What is Bronchoalveolar Lavage

A

Collecting cells from airways during bronchoscopy by washing airways with fluid and then collecting the fluid for testing

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15
Q

What does the bronchoalveolar lavage show in hypersensitivity pneumonitis

A

Raised lymphocytes and mast cells

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16
Q

What is the management of hypersensitivity pneumonitis

A

1- Removing of allergen
2- Oxygen
3- steroids

17
Q

What are the different types of hypersensitivity pneumonitis ( Hint : 4 )

A

1- Bird-fanciers lung : bird droppings
2- Farmers lung : mouldy spores in hay
3- Mushroom workers’ lung : mushroom antigens
4- Malt workers lung : mould on barley

18
Q

What is cryptogenic organizing pneumonia

A

A focal area of inflammation in the lung that is idiopathic or triggered by infection , inflammatory disorder , medications , radiation , or allergens

19
Q

What is the presentation of cryptogenic organizing pneumonia ( Hint : 4 )

A

1- SOB
2- cough
3- fever
4- lethargy

20
Q

How does cryptogenic organizing pneumonia present on chest X-ray

A

Focal consolidation

21
Q

What is the definitive investigation for cryptogenic organizing pneumonia and why

A

Lung biopsy in order to differentiate it from infective pneumonia

22
Q

What is the treatment of cryptogenic organizing pneumonia

A

Corticosteroids

23
Q

What is Asbestosis

A

Lung fibrosis due to inhalation of asbestos

24
Q

What does oncogenic mean

A

something that causes cancer

25
Q

Is asbestos oncogenic or fibrogenic

A

It is Both

26
Q

What problems does asbestos inhalation cause ( Hint : 4 )

A

1- Lung fibrosis
2- Pleural thickening and pleural plaques
3- Adenocarcinoma
4- Mesothelioma