Interstitial Lung Disease Flashcards
4 prototypical ILD symptoms?
Dyspnea, cough, crackles during inspiration, and digital clubbing
ILD evaluation must include history of 5 things?
Occupation, hobbies, environmental, travel and drugs
What are the 5 lung diseases caused by RA?
IPF, bronchiectasis, pulmonary rheumatoid nodules, Pulmonary vasculitis, and pleural disease
What is characteristic of pleural disease that he talked about?
Low pleural glucose
3 lung diseases SLE can cause?
ILD, PHTN and pleural disease
Most common autoantibody in scleroderma associated with ILD?
SCL
2 most common auto antibodies in SLE associated with ILD?
ANA and Histone
What is the chem drug he wants us to know causing ILD?
Bleomycin
What is the cardiac Antiarrhythmics agent he wants us to know causing ILD?
Amiodarone
What is the antibiotic he wants us to know causing ILD?
Nitrofurantoin
What is the early and late phase of ILD after radiation?
1-3 months
6-12 months causing fibrosis
3 symptoms of acute Hypersensitivity pneumonitis?
Dyspnea, cough and fever
What did he say should be our focus with hypersensivity pneumonitis?
Figure out the chronic ones that are silent so they don’t develop irreversible fibrosis
Two big differences between ILD and COPD?
ILD is more rapid decline and COPD is slower decline
ILD has non productive cough and COPD has a very productive cough
What is the treatment choice for non IPF?
Corticosteroids
What are the two drugs for IPF only?
Pirfenidone and nintedanib
What is the clinical characterization and histo characterization of AIP?
Rapid onset of dyspnea and respiratory failure.
Diffuse alveolar damage leading to fibrosis
Next questions are AIP vs. IPF.
What patient population of each?
AIP: all ages, mostly adults
IPF: almost exclusively adults
Chest X ray pattern?
AIP: diffuse, symmetrical and bilateral
IPF: asymmetrical and favors upper or lower lobes.
What is the difference in onset of the two?
AIP: abrupt
IPF: gradual
Best way to diagnose for AIP vs. IPF?
AIP: biopsy
IPF: history, imaging, PFTs
What is the treatment of choice for sarcoidosis?
Prednisone
What is a patient exposed to if they hang out in caves?
Silica
3 lung conditions associated with scleroderma?
Pulmonary fibrosis, pulmonary HTN, and aspiration.
Parasternal heave/lift is associated with what two conditions?
Pulmonary HTN and RV enlargement
What will you see on Chest x ray for asbestos?
Pleural plaques on the periphery
4 things we will see on patient presentation for sarcoidosis?
Erythema Nodosum
Arthralgia
Hilar adenopathy
Fever
What kind of cough is found in hypersensitivity pneumonitis?
Dry cough
Two histo ways to categorize ILD?
Inflammation leading to fibrosis and granulomatous
What is the main difference between interstitial pneumonia and idiopathic fibrosis?
We call a disease or condition UIP when we know the underlying process or cause. We call it idiopathic pulmonary fibrosis when we don’t know the underlying cause.
Big time histo difference between UIP and NSIP?
Honeycombing is in UIP
What diagnostic tool can he crucial to determine distribution and extend of a specific ILD?
High resolution CT
