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respiratory > Interstitial Lung Disease > Flashcards

Interstitial Lung Disease Flashcards

1
Q

How to confirm diagnosis of interstitial lung disease?

A

Clinical features and high resolution CT

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2
Q

What does high resolution CT show?

A

Ground glass appearance

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3
Q

Management of interstitial lung disease?

A

Gone oxygen if hypoxia
Remove or treat underlying cause
Stop smoking
Physiotherapy/ pulmonary rehab
Pneumococcal flu vaccine
Palliative care
Lung transplant

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4
Q

What is idiopathic pulmonary fibrosis?

A

Unknown cause, over 50, sob and dry cough for more than 3 months

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5
Q

What can you find on examination of idiopathic pulmonary fibrosis?

A

Clubbing and i basal fine inspiration crackles

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6
Q

Prognosis of idiopathic pulmonary fibrosis?

A

2-5 years

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7
Q

2 medications that slow progression of idiopathic pulmonary fibrosis?

A
  1. Pirfenidone- antifibrotic and anti-inflammatory
  2. Nintedanib- tyrosine kinase
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8
Q

Drug induced pulmonary fibrosis is caused by?

A

MANC
Methotrexate
Amiodarone
Nitrofunatoin
Cyclophosphamide

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9
Q

Secondary pulmonary fibrosis is due to?

A

RASS
Rheumatoid arthritis
Alpha 1 antitrypsin deficiency
SLE
Systemic sclerosis

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10
Q

What is hypersensitivity pneumonitis?

A

Type 3 reaction- parenchyma inflammation

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11
Q

What would you find with bronchoalveolar lavage in hypersensitivity pneumonitis?

A

Mast cells and lymphocytes

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12
Q

Examples of hypersensitivity pneumonitis?

A

Bird fancier lung: avian proteins from droppings
Farmer lung: saccharopolyspora rectivirgula
Mushroom workers: aspergillus clavatus
Malt workers lung: thermophilic actinomycetes

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13
Q

How to manage hypersensitivity pneumonitis?

A

Oxygen, remove allergen, steroids

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14
Q

Which condition is similar to pneumonia on CXR and had similar symptoms of cough, fever, sob lethargy?

A

Cryptogenic organising pneumonia- lung biopsy definitive investigation.
Treatment systemic corticosteroids

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15
Q

What can asbestosis cause?

A

Lung fibrosis
Pleural thickening and plaques
Adenocarcinoma
Mesothelioma

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16
Q

What would spirometry show in IPF?

A

Restrictive picture: FEV1 normal or reduced and FVC reduced hence FEV1/FVC increased

17
Q

What can IPF cause?

A

Impaired gas exchange, hence reduced transfer factor

18
Q

Investigation of choice in IPF?

A

CT- honeycombing , CXR- bilateral shadowing reticular opacities

19
Q

What does asbestosis normally cause?

A

Lower lung fibrosis

20
Q

Features of asbestosis?

A

Dyspnoea/ reduced exercise tolerance
Clubbing
Bilateral end inspiratory crackles
Restrictive pattern on lung function test and reduced gas transfer

21
Q

Possible features of mesothelioma?

A

Progressive sob
Chest pain
Pleural effusion

22
Q

Mean survival for mesothelioma?

A

8-14 months

23
Q

Which occupations put yo at risk of developing silicosis?

A

Mining, slate works, foundries, potteries

24
Q

What are the features of silicosis?

A

Upper zone fibrosing lung disease, egg shell calcification of hilar lymph nodes

25
Q

What is a risk factor for developing tuberculosis?

A

Inhalation of silica ( toxic to macrophages)

26
Q

How does coal dust cause coal workers pneumoconiosis?

A

Dust in engulfed by alveolar and interstitial macrophages in the bronchioles. They are then moved by the macrophages via the mucocilary elevator and removed from body as mucus. However prolonged exposure causes macrophages to accumulate in alveoli starting an immune response causing damage to lung tissue

27
Q

What are the 2 types of pneumoconiosis?

A

Simple and progressive massive fibrosis

28
Q

What is simple pneumoconiosis?.

A

Most commonest type, patients are asymptomatic. Increases the risk of lung disease COPD. 30% of those with stage 3 will lead to progressive massive fibrosis

29
Q

Staging of simple pneumoconiosis?

A
  1. Some opacities but normal lung markings visible
  2. Large number of opacities but normal lung markings visible
  3. Large number of opacities with normal lung not visible
30
Q

What happens in progressive massive fibrosis?

A

Round fibrotic masses commonly in upper lobes. Patients will be sob and cough, possibly black sputum.

31
Q

What will a lung function test show for progressive massive fibrosis?

A

Obstructive/ restrictive picture

32
Q

What will CXR show for progressive massive fibrosis?

A

Upper zone fibrosis

33
Q

Spirometry for progressive massive fibrosis?

A

Normal or slightly reduced FEV1 but reduced FVC- restrictive

34
Q

Management of pneumoconiosis?

A

Avoid exposure to coal dust and other respiratory irritants (smoking)
Manage symptoms of chronic bronchitis
Patients may be eligible for compensation via the industrial injuries act

35
Q

Presentation of extrinsic allergic alveolitis?

A

Sob, cough fever, in chronic stages productive cough, lethargy , anorexia and weight loss

36
Q

Management of extrinsic allergic alveolitis?

A

Oral glucocorticoids

respiratory (14 decks)

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