interstitial lung disease

Question 1

what is interstitial lung disease

Answer 1

group of conditions affecting the lung parenchyma, causing inflamamtion and fibrosis

scar replaces functional lung tissue

Question 2

diagnosing ILD

Answer 2

clinical features
high resolution CT
lung biopsy + histology

Question 3

finding on CT

Answer 3

ground glass appearance

Question 4

management options

Answer 4

remove/treat underlying cause
home O2 if hypoxic at rest 
stop smoking 
physio
pneumococcal + fly vaccine

Question 5

idiopathic pulmonary fibrosis

Answer 5

progressive pulmonary fibrosis with no clear cause

Question 6

idiopathic pulmonary fibrosis presentation

Answer 6

insidious onset SOB and dry cough > 3mo

Question 7

idiopathic pulmonary fibrosis O/E

Answer 7

bibasal fine inspiratory crackles

finger clubbing

Question 8

idiopathic pulmonary fibrosis medications to slow progression

Answer 8

pirfenidone

nintedanib

Question 9

pirfenidone

Answer 9

antifibrotic + antiinflammatory

Question 10

nintedanib

Answer 10

monoclonal antibody against tyrosine kinase

Question 11

drug induced pulonary fibrosis : causative drugs

Answer 11

amiodarone
cyclophosphamide
methotrexate
nitrofuratoin

Question 12

secondary pulmonary fibrosis : causative conditions

Answer 12

alpha-1 antitripsin deficiency
RA
SLE
systemic sclerosis

Question 13

hypersensitivity pneumonitis

Answer 13

T3 hypersensitivity reaction to an environmental allergen that causes parenchymal inflammation + destruction

Question 14

bronchoalveolar lavage

Answer 14

collect cells from airways during bronchoscopy by washing airways with fluid then collecting that fluid for testing

Question 15

hypersensitivity pneumonitis: bronchoalveolar lavage findings

Answer 15

raised lymphocytes

mast cells

Question 16

hypersensitivity pneumonitis management

Answer 16

remove allergen
O2 where necessary
steroids

Question 17

hypersensitivity pneumonitis - specific causes

Answer 17

farmer’s lung - mouldy spores

bird-fanciers lung - bird droppings

Question 18

cryptogenic organising pneumonia

Answer 18

focal area of inflammation of lung tissue

Question 19

cryptogenic organising pneumonia causes

Answer 19

idiopathic

triggered by

• infection
• inflammatory disorders
• medications
• radiation
• environmental toxins/allergens

Question 20

cryptogenic organising pneumonia presentation

Answer 20

SOB
cough
fever
lethargy

Question 21

cryptogenic organising pneumonia definitive investigation

Answer 21

lung biopsy

Question 22

cryptogenic organising pneumonia management

Answer 22

systemic corticosteroids

Question 23

asbestosis

Answer 23

lung fibrosis related to inhalation of asbestos

Question 24

asbestos inhalation causes several problems

Answer 24

lung fibrosis 
pleural thickening 
pleural plaques
adenocarcinoma 
mesothelioma