Interstitial lung disease Flashcards

1
Q

What are the main types of interstitial lung disease?

A

Usual interstitial pneumonia

Non-specific interstitial pneumonia

Extrinsic Allergic alveolitis

Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What investigations should you consider ordering for patients with interstitial lung disease?

A

ANA

ENA

RhF

ANCA

Anti-GBM

ACE

IgG to serum precipitins

HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What classical findings will you find on examination with a patient with interstitial lung disease?

A

Clubbing of the fingers

Reduced chest expansion

Fine inspiratory crepitations on auscultation - usually heard over the basal and axillary areas

Cardiovascular - may be features of cor pulmonale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is extrinsic allergic alveolitis?

A

This is also known as hypersensitivity pneumonitis.

Acute - short period from exposure and is usually reversible.

Chronic - chronic exposure to an allergen for months to years and this is less reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is sarcoidosis?

A

This is a multi-system inflammatory condition of unknown cause

Non caseating granulomas on histology

Immunological response

50% patients get spontaneous remission but others get progressive disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What investigations would you order for sarcoidosis?

A

Pulmonary function testing

CXR

Bloods: Renal function, bone profile, ACE

Urinary calcium

ECG, echo, cardiac MRI

CT/MRI head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the treatment principles for interstitial lung disease?

A

Remove any offending factors such as drugs and occupational exposure

Smoking cessation

Consider LTOT in severe cases

Pulmonary rehabilitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the pharmacological management for interstitial lung disease?

A

N-acetylcysteine

Pirfenidone

Immunosuppressants

can all be considered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is interstitial lung disease diagnosed?

A

Using spirometry: FEV1:FVC ratio is preserved but both FEV1 and FVC are separately reduced.

CXR: May show signs including broken glass appearance due to increased radiopacity as a result of fibrotic scarring. This can progress to honeycombing appearance on a CXR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly