Interstitial Lung Diseases Flashcards
What is ILD? (2 things)
- Umbrella term for conditions that affect lung parenchyma: esp Pulmonary CT in alveolar walls
- Characterized by Inflamm + Fibrosis
What is Lung fibrosis?
Replacement of normal elastic + functional tissue w scar tissue that is stiff + ineffective function
What are the CF of ILD? (4 + 3 things)
- Fatigue
- SOB on exertion
- Dry cough
- Abn breath sounds
@exam
- End respiratory fine crackles @ lung bases
- Cyanosis (severe)
- Clubbing (severe)
What tests should you do for sus ILD? (5 things)
- XR
- High res CT
- Spirometry
- Diffusing capacity of Lungs for Carbon Monoxide (DLCO)
- Biopsy (if diagnosis unclear)
What will a High res CT show in ILD?
“Ground glass” opacity appearance
What will the Spirometry test show in ILD?
Restrictive pulmonary spirometry
What will the Diffusing capacity of Lungs for Carbon Monoxide (DLCO) show in ILD?
Reduced Diffusing Capacity of Lungs for CO (DLCO)
What is the general prognosis for ILD?
Poor prognosis bc damage is irreversible
What are the general management options for ILD? (6 things)
- Treat underlying cause
- Home oxygen (if hypoxic @ rest)
- X Smoking
- Physio + Pulmonary rehab
- Lung transplant
- Palliative (if needed)
What is Idiopathic Pulmonary Fibrosis? (2 things)
A type of ILD with:
- No clear cause
- Progressive pulmonary fibrosis
How does Idiopathic Pulmonary Fibrosis present? (2 things)
- SOB
- Dry cough
(gradual onset over 3+ months)
What can be seen @ exam of Idiopathic Pulmonary Fibrosis? (2 things)
- End respiratory fine crackles @ lung bases
- Clubbing
What are the medications given to slow down the progression of Idiopathic Pulmonary Fibrosis? (2 things)
- Pirfenidone (anti-fibrotic + anti-inflamm)
- Nintedanib (monoclonal antibody vs Tyrosine kinase)
What medications cause Drug Induced Pulmonary Fibrosis? (4 things)
- Amiodarone (antiarrhythmic for tachycardia)
- Cyclophosphamide (chemo)
- Methotrexate (chemo / AI conditions / induce abortions)
- Nitrofurantoin (abx for bladder infections)
What conditions lead to Secondary Pulmonary Fibrosis? (4 things)
- Alpha-1 antitripsin deficiency
- RA
- Systemic lupus erythematosus (SLE)
- Systemic sclerosis
What is Hypersensitivity Pneumonitis (AKA Extrinsic Allergic Alveolitis)? (2 things)
- A type of ILD
- A type 3 hypersensitivity reaction to environmental allergen
How do you investigate for Hypersensitivity Pneumonitis (AKA Extrinsic Allergic Alveolitis)?
Bronchoalveolar lavage
(@ Bronchoscopy: Wash airways w fluid n Collect fluid for testing)
What would the Bronchoalveolar lavage show in Hypersensitivity Pneumonitis (AKA Extrinsic Allergic Alveolitis)? (2 things)
- High lymphocytes
- High mast cells
What is Cryptogenic Organising Pneumonia?
A type of ILD involving focal area of inflamm of lungs
What are the causes of Cryptogenic Organising Pneumonia? (6 things)
- Idiopathic
- Infection
- Inflamm disorders
- Medications
- Radiation
- Environmental toxins / allergens
What condition does Cryptogenic Organising Pneumonia present very similarly to?
Infectious Pneumonia
What are the CF of Cryptogenic Organising Pneumonia? (4 things)
- SOB
- Dry cough
- Fever
- Lethargy
What is the definitive diagnosis method for Cryptogenic Organising Pneumonia?
Lung biopsy
What is the treatment for Cryptogenic Organising Pneumonia?
Systemic corticosteroids
