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Pulmonology > Interstitial Lung Disease > Flashcards

Interstitial Lung Disease Flashcards

1
Q

What is interstitial Lung disease?

A

Group of disorders:
cellular infiltration
scarring or architectural disruptionof pulm parenchyma

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2
Q

What is the clinical presentation of ILD?

A

Progressive dyspnea on exertion
Dry cough
Restrictive physiology
Abn Chest Radiograph/CT with interstitial infiltrates/ground glass

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3
Q

What is significant in past history in ILD?

A 
Occupational Exposure
-Dust, silica, asbestos
-farms, silos
-Fumes
Drugs: 
-Amiodarone
-Nitrofurantoin
Connective Tissue Disease
Cigarette Smoking
Family History
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4
Q

What is seen on PE in ILD?

A 
Clubbing 
Skin and Soft tissue changes: 
Erythema nodosum, arthritis, rash
Tachypnea
Dry Crackles on ausc
Inc Right Heart Pressures
Inc P2, TR murmur, edema, JVD
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5
Q

What is seen on Pulmonary Function test in ILD?

A

Same morphology as normal. Volumes are just decreased.

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6
Q

What are radiographic Findings in ILD?

A 
Nodules 
Honeycombing
Migratory Pattern
Septal thickening 
Pleural disease
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7
Q

Which disease in ILD has the worst prognosis?

A

Idiopathic Pulmonary Fibrosis

Acute interstitial Pneumonia (high mortality)

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8
Q

What is the clinical presentation of Idiopathic Pulmonary Fibrosis?

A 
Chronic and Progressive
Dyspnia on Exertion
Non-productive cough
Bibasilar inspiratory velcro-like crackles
Clubbing
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9
Q

What is seen on Radiograph of Idiopathic Pulmonary Fibrosis?

A

Lower lobes and peripheral distribution of reticular infiltrates and fibrotic changes

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10
Q

What is the management of Idiopathic Pulmonary Fibrosis?

A

Conventional Immunosupressive therapy: Acetyl cysteine, Interferon Gamma,
etanercept, Show poor response.
Pirfenidone and Ninedanib(new)

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11
Q

What is charicteristic of Non-specific interstitial pneumonitis?

A

Temporal Homogeneity, HIV infection, hypersensitivity pneumonitis
Better prognosis than IPF

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12
Q

What is seen on radiograph of NSIP?

A

Ground Glass Opacity in lower lung zones, with or without reticular infiltrates
Honeycombing uncommon

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13
Q

What is Desquamative Interstitial Pneumonitis?

A

Affects current or former smokers
Peribronchiolar accumulation of pigmented macrophages
Diffuse or patchy areas of ground glass appearance

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14
Q

What is charicteristic of AIP and DAD?

A

Diffuse Bilateral air space and reticular infiltrates
Presence of ARDS picture and histologic confirmation of diffuse alveolar damage
Supportive care is Tx
Leads to chronic Interstitial Lung disease

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15
Q

What is Cryptogenic Organizing Pneumonia?

A

2/3 of Pt are non-smokers
Clin Pres resembles LRI that doesn’t respond to Abtx
Tx is Corticosteroids

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16
Q

What is radiograpic Appearance of COP?

A

Patchy infiltrates unilateral or bilateral
Small nodular opacities
Consolidation and air bronchogram seen on HRCT
Subpleural and Peribronchial dist.

17
Q

What is Hypersensitivity Pneumonitis?

A

Repeated exposure to organic and chemical antigens

RF: Thermophilic bacteria, Non-TB mycobacteria, fungal species, bird feathers

18
Q

What is the Acute Presentation of Hypersensitivity Pneumonitis?

A

Abrupt Onset
Tachypnea and Diffuse Fine crackles
CXR shows transient patchy, microodular opacities
Tx: Remove from exposure to inciting antigen => improvement in symptoms

19
Q

What is the Chronic Presentation of Hypersensitivity Pneumonitis?

A

Clubbing

Irreversible resp findings due to pulmonary fibrosis are charicteristic(looks like IPF)

20
Q

What is the Radiographic appearance of Hyp Pneumo?

A

Ground Glass Opacification and Centrilobar Lobules

21
Q

What is the cause of Drug induced ILD? Heart

A

Amiodarone: Interstitial Pneumonitis
Long elimination half life 45-60d
Stop Amiodarone and Start Oral steroids

22
Q

What is the cause of Drug induced ILD? Renal

A

Nitrofurantoin

Peripheral Blood Eosinophelia

23
Q

What is Chronic Eosinophilic Pneumonia? Radiographic?

A

^^^Subpleural Consolidation Predominantly upper lobes

Negative image of Pulm Edema

24
Q

What is Lymphangioleiomyomatosis?

A 
Progressive Lung disease
Affects women in Childbearing age
Proliferation of atypical smooth muscle cells 
Pneumothorax 50% of presentation
Diffusely distributed Thin walled cysts

Pulmonology (18 decks)

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