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Resp AM > Interstitial lung disease > Flashcards

Interstitial lung disease Flashcards

1
Q

What causes fibrosis in the upper zones?

A 
CHARTS 
Coal worker's pneumoconiosis 
Hypersensitivity pneumonitis 
Ankylosing spondylitis 
Radiation 
TB 
Sarcoidosis/silicosis
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2
Q

What causes apical fibrosis?

A

Ank spond

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3
Q

What causes lower zone fibrosis?

A 
IRA SAD
Idiopathic pulmonary fibrosis
RA
Aspiration pneumonia 
Scleroderma 
Asbestosis 
Drugs
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4
Q

What is sarcoidosis?

A

Multisystem granulomatous disorder of unknown cause

Characterised by non caseating granulomas

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5
Q

Who is sarcoidosis seen in?

A

20-40yo
Women
Afro-Caribbean more

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6
Q

What is the presentation of sarcoidosis?

A 
Acute= fever, erythema nodosum, polyarthralgia, bilateral hilar lymphadenopathy 
Non productive cough, dyspnoea, wheeze 
Chronic fatigue, weight loss 
Arthralgia 
Lymphadenopathy 
Uveitis
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7
Q

What investigations are done for sarcoidosis?

A 
CXR 
Bloods- FB, U&Es, LFTs, Ca
Lung function tests 
Biopsy 
ECG
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8
Q

What is seen on CXR with sarcoidosis?

A

Bilateral hilar lymphadenopathy
Pulmonary fibrosis- upper zone dominance
Displaced hilum

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9
Q

What is the management of sarcoidosis?

A

Corticosteroids if symptomatic, eye, heart or near involvement, or hypercalcaemia

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10
Q

What is usual interstitial pneumonitis?

A

Umbrella term for progressive fibrosis and chronic inflammation of interstitium

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11
Q

What can cause usual interstitial pneumonitis?

A 
Idiopathic 
Connective tissue disease- usually RA 
Drug induced pulmonary fibrosis 
Post infection 
Industrial exposure- asbestosis, silicosis
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12
Q

What drugs can cause drug induced pulmonary fibrosis?

A 
Amiodarone 
Methotrexate 
Sulfasalazine 
Cyclophosphamide 
Nitrofurantoin
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13
Q

What is the presentation of asbestosis?

A

SOB, dry cough
Reduced exercise tolerance
Lower lobe fibrosis
Associated with mesothelioma

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14
Q

What investigations are done for usual interstitial pneumonitis?

A

CXR

CT

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15
Q

What is the appearance of UIP on CXR?

A

Honeycomb damage of peripheries and lower portions of lungs

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16
Q

What is the management of UIP?

A

Oxygen therapy

Lung transplant

17
Q

What is the prognosis for UIP?

A

Very variable

Generally 3-5years

18
Q

What is idiopathic pulmonary fibrosis?

A

Excessive collagen deposition in pulmonary interstitium

19
Q

Who is idiopathic pulmonary fibrosis seen in?

A

60-70yo

Men > women

20
Q

What is the presentation of idiopathic pulmonary fibrosis?

A 
Insidious onset SOB 
Dry cough 
Clubbing 
Bibasal inspiratory crackles 
Weight loss
21
Q

What investigations are done for idiopathic pulmonary fibrosis?

A

CT= imaging of choice
CXR
Spirometry
Biopsy

22
Q

What is the appearance of idiopathic pulmonary fibrosis on CXR?

A

Bilateral interstitial shadowing

Ground glass appearance –> honeycomb

23
Q

What is the management of idiopathic pulmonary fibrosis?

A

Antifibrotic
Lung transplant
Pulmonary rehab

24
Q

What is the prognosis for idiopathic pulmonary fibrosis?

A

Poor

25
Q

What is hypersensitivity pneumonitis?

A

Inflammation of alveoli caused by type III and IV hypersensitivity reactions

26
Q

What are some examples of hypersensitivity pneumonitis?

A

Bird fancier’s lung

Farmer’s lung

27
Q

What is the presentation of hypersensitivity pneumonitis?

A 
Acute= 4-8 hours after exposure 
-SOB, dry cough, fever
Chronic
-SOB, cough, crackles, wheeze
-low grade illness
28
Q

What investigations are dene for hypersensitivity pneumonitis?

A

FBC, CRP, ESR= no eosinophilia
CXR= upper/mid zone fibrosis
Bronchoalveolar lavage= raised lymphocytes and mast cells

29
Q

What is the management of hypersensitivity pneumonitis?

A

Avoid allergen

Corticosteroids

30
Q

What is the presentation of pulmonary eosinophilia?

A

Cough
Weight loss
Night sweats

31
Q

What investigations are done for pulmonary eosinophilia?

A

CXR
FBC= high eosinophils
Bronchoalveolar lavage= eosinophilia

32
Q

What is the management of pulmonary eosinophilia?

A

Steroids

33
Q

What is the presentation of allergic bronchopulmonary aspergillosis?

A

SOB, wheeze, cough
Proximal bronchiectasis
Previous diagnosis of asthma

34
Q

What investigations are done for allergic bronchopulmonary aspergillosis?

A

FBC, IgA= raised
CXR
Aspergillus= +

35
Q

What is the management of allergic bronchopulmonary aspergillosis?

A

Steroids

36
Q

What are the stages of sarcoidosis?

A 
1= bilat hilar lymphadenopathy
2= BHL + interstitial infiltrates 
3= diffuse interstitial infiltrates 
4= diffuse fibrosis

Resp AM (17 decks)

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