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Undeleted > Interstitial lung disease > Flashcards

Interstitial lung disease Flashcards

1
Q

2 genreal types of ILD

A
  1. upper lobe

2. lower lobe

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2
Q

DDX for upper (5)

A 
FASST
Farmer's lung (hypersensitivity)
Ank spond
Silicosis
Sarcoidosis
TB
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3
Q

what is farmer’s lung (HP)

A
  • from repeated exposures
  • type 3 or 4 hypersens
  • can be weeks to years
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4
Q

**4 general causes of HP and their subtypes to know

A
  1. microbial
    - farmer - thermophillic
    - tobacco - asperilligus
    - hot tub - mycobacterium avium
  2. animal protein
    - bird fancier
    - also comforters
  3. LMW chems
    - isocyanates
    - popcorn lung - butter flavor
  4. meds
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5
Q

what is presentation of HP

A
  • can be non-specific, but should be temporally related
  • resp Sx
  • constitutional Sx
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6
Q

3 timeframes of HP

A

acute - 4-6hrs
subacute - wks/months
chronic - long term with progressive fibrosis

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7
Q

5 things for HP Dx

A
  1. exposure to antigen causes HP
  2. clinical syndrome consitent with HP
  3. PFT abnormalities - obs, rest, or both with low DLCO
  4. radiographic abnormalities
  5. supportive cyto/pathology
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8
Q

2 Tx of HP

A
  1. removal of pathogen

2. immunosupression

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9
Q

what is silicosis

A
  • occupational exposure to silical dust

- variable Sx

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10
Q

what is silicosis PFT

A

restriciton with low DLCO

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11
Q

imaging in silicosis

A

upper lobes nodules and calcificatiokns

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12
Q

what is sarcoidosis

A

inflammation rxn of non-caseating granulomatous inflammation

  • cuase unknown
  • can be anywhere in body, but 90% have lung
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13
Q

4 different presentation of sarcoidosis

A
  1. incidental findings (stage 1)
  2. resp Sx (stage 2,3,4
  3. loffgrens (subtype of 1)
  4. extra-pulmonary Sx
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14
Q

what is staging in sracoidosis

A

based on radiographic features

  1. incidental findings of hilar adenopathy
  2. hilar adenopathy and upper lobe nodules
  3. upper lobe ILD with fibrosis
  4. end stage fibrosis of the upper lobes
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15
Q

what are chances of spontaneous remission

A
  1. 70-90%
  2. 50-70
  3. 10-30
  4. 0
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16
Q

what is lofgrens

A
  • subgroup of stage 1
  • hilar adenopathy
  • fever
  • polyarthralgias/arthrirtis
  • erythemia nososum
17
Q

4 extrapulm. presentations of sarcoidosis

A
  1. skin lesions
  2. ocular
  3. Ca metabolism
  4. cardiac - conduction Sx
18
Q

4 parts of sarcoidosis Dx

A
  1. CXR show abnormalities
  2. may or may not have Sx
  3. PFT - obs or rest with low DLCO
  4. path - granulomatous inflammation
19
Q

Tx of sarcoidosis

A

1-2 - nothing

3-4 prednisone

20
Q

DDx for lower lobe ILD (6)

A 
RAAIDS
Rhem arth
Asbestosis
Aspirations
Idiopathic pulm fibrosis
Drugs
Scleroderma
21
Q

what is connective tissue ILD

A

most rheumatic conditions can cause ILD

- leading cause of death in rheumatic conditons

22
Q

2 rheumo conditions

A
  1. RA - uncommon manifestation of common dis

2. scleroderma - common manif. of uncommon disease

23
Q

2 things for diagnosis of CT-ILD

A

Hx and Phx

serology

24
Q

what is asbestsis

A
  • occurs 20-30 years after exposure

- need significant exposure

25
Q

what is manifestion of asbestosis

A

lower lobe ILD - other things are cause by asbestos, but not asbestosis

26
Q

Dx and Tx of asbestosis

A

Dx- Hx and fibers seen on patho

Tx - none

27
Q

what is idiopathic pulm fibrosis

A

age >50

  • seems to be abberant wound healing without significant inflammation
  • uncommon
  • survivial 2-5 years
28
Q

3 things to make IPF Dx

A
  1. rule out all other caues of ILD
  2. CT showing “usual interstitial pneumonia”
  3. may need lung biopsy
29
Q

what is Tx for IPF

A
  • NOT steroids - increases mort

- anti-fibrotic agents

30
Q

5 things to include on an ILD Hx

A
  1. resp Sx
  2. CT disease Sx
  3. toxins
  4. exposures
  5. risk factors
31
Q

3 parts of PhX for ILD

A
  1. resp exam
  2. cardiac exam
  3. rheum exam
32
Q

5 tests to order for ILD

A
  1. PFT
  2. CXR
  3. CT
  4. bloods -serology, Ca,
  5. path - if haven’t figured it out

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