Interstitial lung disease (ILD) Flashcards
What is the first line treatment for SSc-ILD as per british society of rheumatology?
A) Cyclophosphamide
B) Mycophenolate Mofetil
C) Rituximab
D) Tocilizumab
E) Pirfendione
B) Mycophenolate Mofetil
MMF is recommended as first-line treatment. Rituximab and/or CYC by i.v. infusion may be used as an alternative.
- The 2024 British Society for Rheumatology guideline for management of systemic sclerosis—executive summary
When should you consider tocilizumab in SSC-ILD?
Consider tocilizumab as first-line treatment in early dcSSc with raised inflammatory markers and ATA positivity, independent of the extent of ILD on CT.
You have a patient with SSc-ILD on MMF. You are considering rescue immunomodulatory therapy. what drugs are suitable?
Consider adding rituximab or tocilizumab to background treatment with MMF or other immunosuppressant, as rescue immunomodulatory therapy
You see a patient with life threatening pulmonary haemorrhage secondary to vasculitis.
What is the best initial treatment?
A) IV methylprednisolone only
B) IV methylprednisolone and MMF
C) IV methylprednisolone and Rituximab/cyclophosphamide
D) IV methylprednisolone and Tocilizumab
E) Oral dexamethasone
C) IV methylprednisolone and Rituximab/cyclophosphamide
For induction of remission in patients with new-onset or relapsing GPA or MPA with organ-threatening or life-threatening disease, we recommend treatment with a combination of glucocorticoids and either rituximab or cyclophosphamide.* Rituximab is preferred in relapsing disease.†
You see a patient with non-life threatening GPA
What is the best initial treatment for induction?
For induction of remission of non-organ-threatening or non-life-threatening GPA or MPA, treatment with a combination of glucocorticoids and rituximab is recommended. Methotrexate or mycophenolate mofetil can be considered as alternatives to rituximab.
Which underlying autoimmune condition is most associated with organising pneumonia?
A) Ankylosing spondylitis
B) Polymyositis
C) Sjogren’s syndrome
D) Systemic Sclerosis
E) SLE
B) Polymyositis
OP is also associated with Dermatomyositis and anti-synthetase syndrome
Mechanics hands are related to which disease?
A) Antisynthetase syndrome
B) Bronchiectasis
C) COPD
D) IPF
E) Rheumatoid ILD
A) Antisynthetase syndrome
Of the anti-synthetase antibodies, anti-Jo-1, an anti-histidyl-tRNA synthetase, is most commonly identified.
Which of the below drugs is most associated with organising pneumonia?
A) Apixaban
B) Bisoprolol
C) Rituximab
D) Nitrofurantoin
E) Methotrexate
C) Rituximab
Other drugs that are common include: Amiodarone, interferons, minocycline, and statins
You see a patient with suspected Alpha-1-antitrypsin deficiency.
What is the usual pattern of emphysema you will see?
A) Apical predominant
B) Basal Predominant
C) Hilar predominant
D) Periphery predominant
E) None of the above
B) Basal Predominant
Cocaine smoking is associated with which of these conditions?
A) EGPA
B) GPA
C) Goodpasture’s syndrome
D) SSc- ILD
E) Polymyositis
C) Goodpasture’s syndrome
Insults to the lungs are probably required to produce both the renal and pulmonary disease.
There is a strong genetic linkage to HLA-DRB1.4 6
Exposure to organic solvents or hydrocarbons.
Smoking.
Infection - eg, influenza.
A case in a heavy smoker who had taken to using crack cocaine is described.
Exposure to metal dusts.
It can occur after renal transplantation in Alport’s syndrome.
