Interstitial Lung Disease

Question 1

What is ILD

Answer 1

Umbrella term to describe conditions which affect the lung parenchyma causing inflammation and fibrosis

Question 2

Diagnosis of ILD

Answer 2

Combination of clinical features and high resolution CT scan of the thorax

Question 3

What does a high resolution CT scan show

Answer 3

Ground glass appearance with ILD

Question 4

Management of ILD

Answer 4

Poor prognosis and limited management as damage is irreversible

Question 5

Types of ILD

Answer 5

Idiopathic pulmonary fibrosis, drug induced pulmonary fibrosis, secondary pulmonary fibrosis, hypersensitivity penumonitis, cryptogenic organising pneumonia, asbestosis

Question 6

What is idiopathic pulmonary fibrosis

Answer 6

Progressive pulmonary fibrosis with no clear cause

Question 7

Presentation of idiopathic pulmonary fibrosis

Answer 7

Insidious onset SOB and dry cough over more than 3 months

Question 8

Examination of patient with idiopathic pulmonary fibrosis

Answer 8

Bibasal fine inspiratory crackles and finger clubbing

Question 9

Medications which can slow the progression of idiopathic pulmonary fibrosis

Answer 9

Pirfenidone and Nintedanib

Question 10

Drugs which can cause pulmonary fibrosis

Answer 10

Amiodarone, Cyclophosphamide, Methotrexate and Nitrofurantoin

Question 11

Conditions which can cause secondary pulmonary fibrosis

Answer 11

Alpha-1 antitripsin deficiency, rheumatoid arthritis, SLE, systemic sclerosis

Question 12

What is hypersensitivity pneumonitis

Answer 12

Type 3 hypersensitivity reaction to an environmental allegen which causes parenchymal inflammation

Question 13

What does bronchoalveolar lavage involve

Answer 13

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

Question 14

What will bronchoalveolar lavage show

Answer 14

Raised lymphocytes and mast cells

Question 15

Management of hypersensitivity pneumonitis

Answer 15

Removing allergen, giving oxygen where necessary and steroids

Question 16

Examples of specific causes of hypersensitivity pneumonitis

Answer 16

Bird-fanciers lung, Farmers lung, Mushroom workers lung, Malt workers lung

Question 17

What is cryptogenic organising pneumonia

Answer 17

Focal area of inflammation of the lung tissue.

Question 18

Cause of cryptogenic organising pneumonia

Answer 18

Idiopathic or triggered by infection, inflammation disorders, medications, radiation, or environmental toxins or allergens

Question 19

Presentation of cryptogenic organising pneumonia

Answer 19

SOB, cough, fever, lethargy, focal consolidation

Question 20

Treatment of cryptogenic organising pneumonia

Answer 20

Systemic corticosteroids

Question 21

What problems can asbestos inhalation cause

Answer 21

Lung fibrosis, pleural thickening, pleural plaques, adenocarcinoma, mesothelioma

Question 22

Causes of pulmonary fibrosis

Answer 22

Lung damage, irritants, diffuse parenchymal lung disease, connective tissue disease, medications and hypersensitivity pneumonitis

Question 23

Symptoms of idiopathic lung fibrosis

Answer 23

Dry cough, SOB, fatigue, arthralgia, cyanosis, clubbing, crackles

Question 24

Complications of pulmonary fibrosis

Answer 24

Type 2 respiratory failure, increased risk of lung cancer, cor pulmonale, mortality

Question 25

Imaging results of pulmonary fibrosis

Answer 25

Bilateral lower zone reticulo-nodular shaddowing, honeycomb lung on CT

Question 26

Management of pulmonary fibrosis

Answer 26

Pulmonary rehab, LTOT, antibiotics, control of RHF, long transplant