Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

clinical medicine II exam 2 > interstitial lung dz > Flashcards

interstitial lung dz Flashcards

1
Q

interstitial lung disease is also known as

A

pulmonary fibrosis

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

in interstitial lung disease, the lung is affected in what 3 ways

A
  1. lung parenchyma is damaged
  2. walls of alveoli become inflamed
  3. scarring (fibrosis) begins and lungs become stiff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

interstitial lung disease has what primary clinical presentation

A
  • progressive dyspnea on exertion and nonproductive cough
  • wheezing and CP are uncommon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

PE is consistent with

  • crackles at lung bases
  • inspriatory squeaks
  • cor pulmonale
  • cyanosis and digital clubbing (advanced dz)
A

interstitial lung disease

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

what abnormal CXR findings are consistent with interstitial lung disease

A
  • ground-glass appearance: often early finding
  • bilateral opacities, reticular “net-like” (most common)
  • honeycombing indicated poor prognosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

pulmonary function tests reveal that most interstitial lung disease are . TLC will be? FEV1/FVC ratio?

A
  • restrictive
  • TLC decreased
  • FEV1 and FVC decreased but ratio is normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

contrary to other interstitial lung diseases, sarcoidosis has what pattern on PFT

A

obstructive

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

expected diffusing capacity of lung for CO (DLCO) in interstitial lung disease

A
  • reduced
  • ability of gas to cross from air -> interstitium -> blood is diminished due to inflammation of alveolar wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

expected ABG in interstitial lung disease

A
  • may be normal
  • may show hypoxemia or respiratory alkalosis
    • increased RR -> decreased PaCO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is bronchoalveolar lavage

A
  • extension of bronchoscopy
  • allows for cellular analysis
  • may help narrow DDx, define stage of disease, assess progress or response to therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the gold standard to diagnose interstitial lung disease

A

lung biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

provide indications when lung biopsy is indicated

A
  • atypical or progressive symptoms
  • age >50 yo
  • fever, weight loss, hemoptysis
  • ILD symptoms with normal or atypical CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

list complications of interstitial lung disease

A
  • pulmonary HTN -> Cor pulmonale (rt ventricular hypertrophy) -> Rt heart failure
  • pneumothorax (alveoli become so stiff, they rupture)
  • elevated CA risk
  • progressive respiratory insufficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is often the initial procedule of choice for lung biopsy

A

transbronchial lung biopsy

  • less invasive, less tissue for analysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

known occupation and environmental causes of interstitial lung disease

A
  • inorganic dust (asbestos, silica, hard metals)
  • organic dust (bacteria, animal proteins)
  • gases, fumes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

known drug cause of interstitial lung disease

A
  • chemo
  • abx: macrobid
  • radiation treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

interstitial lung disease is associated with what diseases

A
  • sarcoidosis
  • connective tissue or autoimmune
    • scleroderma
    • SLE
    • RA
    • polymyositis
    • systemic vasculitis (granulomatosis with polyangitis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is Pneumoconiosis

A
  • any disease of the respiratory tract due to inhalation of dust particles
    • asbestosis, silicosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when does asbestosis present

A
  • due to chronic inhalation of asbestos fibers
  • usually presents 10-15 yrs of exposure
    • age 40-75 yo
    • m>f
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

asbestos is linked to causing what conditions

A
  • bronchogenic (lung) CA
    • smoking increases risk
  • malignant mesothelioma
21
Q

What is mesothelioma

A
  • form of CA almost always associated with asebestos exposure
  • CA in mesothelium (protective lining that covers most organs)
    • most common in pleura
22
Q

What CXR findings are consistent with asbestosis

A
  • opacities in lower lungs, thickened pleura, pleural plaques
23
Q

how is asbestosis diagnosed?

A
  • consistent hx, PE, symptoms and CXR
  • open lung bx will provide definitive diagnosis but usually not indicated
24
Q

asbestosis will have what findings on PFT

A
  • restrictive
    • decreased TLC
    • FEV1/FVC normal
25
Q

asbestosis management

A
  • consult pulmonology
  • smoking cessation
  • no effective therapy
  • vaccinate: influenza, pneumovax
26
Q
  • male
  • 50ish
  • pipefitter
  • smoker
  • CXR: pleural plaques
A

asbestosis

27
Q

prognosis of asbestosis

A
  • lung damage is irreversible
  • smoking + asbestosis = 59 x more likely to get lung CA
28
Q

which type of pneumoconiosis is characterized by fibronodular lung disease

A

silicosis

29
Q

what causes silicosis

A

inhalation of silica dust

  • occupations: mining, construction, granite cutting, pottery making
30
Q

presentation

  • 10-12 years exposure
  • may be asymptomatic
  • non-progressive once exposure elimiated
  • hilar node calcification (eggshell pattern)
  • small round opacities on CXR
A

chronic simple silicosis

31
Q

presentation

  • >20 years exposure
  • progressive even after exposure eliminated
  • tachypnea, prolonged expiration, rhonchi, wheezing
  • digital clubbing (uncommon)
  • cyanosis (advanced)
  • cor pulmonale (advanced)
  • CXR: enlarging opacities that can cavitate
  • PFT: restrictive
A

chronic complicated silicosis

32
Q

management of chronic complicated silicosis

A
  • consult pulmonologist
  • smoking cessation
  • no specific therapy
  • vaccinate: influenza, pneumovax
33
Q

which condition is associated with noncaseating granulomas, predominantly in the lungs, but can affect heart, liver, spleen, joints, bone

A

sarcoidosis

34
Q

sarcoidosis normally affects what patient population

A
  • african american
  • 20-40 yo
  • slight female predominance
35
Q

clinical presentation

  • fever, anorexia, arthralgias (45% of people)
  • dyspnea on exertion, cough, CP
  • arthritis, cranial nerve palsies, visual disturbances, erythema nodusum
  • PFT: restrictive
A

sarcoidosis

36
Q

what is the most common pattern of lymphadenopathy in sarcoidosis

A
  • bilateral symmetric hilar and right paratracheal mediastinal adenopathy
37
Q

increased serum ACE is associated with what ILD condition

A

sarcoidosis

38
Q

managment of sarcoidosis

A
  • consult pulmonologist
  • 75% require only symptomatic -> NSAIDs
  • corticosteroids: mainstay of therapy
39
Q

what is granulomatosis with polyangitis

A
  • immune-mediated systemic vasculitis
40
Q

which ILD condition is associated with necrotizing granulomas of the upper and lower respiratory tract and glomerulonephritis

A

granulomatosis with polyangitis

41
Q

granulomatosis with polyangitis usually affects what patient population

A
  • white
  • male
  • presents 40-50s
42
Q

clinical presentation

  • upper airway
    • rhinorrhea, purulent/bloody nasal dx
    • oral/nasal ulcers
  • lower airway
    • dyspnea, cough, pleuritic pain, hemoptysis
  • PFT: restrictive or obstructive; decreased DLCO
  • CT: blood vessels leading to nodules and cavities
A

granulomatosis with polyangitis

43
Q

which condition is associated with a + ANCA: antineutophil cytoplasmic antibody, usually C-ANCA

A

granulomatosis with polyangitis

44
Q

managment of granulomatosis with polyangitis

A
  • consult rheumatologist
  • tx: cyclophosphamide (immunosuppressant) and glucocorticoid
45
Q

what is the most common idiopathic interstitial pneumonias

A

idiopathic pulmonary fibrosis

46
Q

how is idiopathic pulmonary fibrosis diagnosed

A
  • diagnosis made after excluding other causes of ILD
  • lung biopsy
47
Q

what is interstitial pneumonitis

A

another name for idiopathic pulmonary fibrosis

48
Q

what patient population is associated with idiopathic pulmonary fibrosis

A
  • male
  • 60s
  • a common man
  • smoker
49
Q

managment of idiopathic pulmonary fibrosis

A
  • consult pulmonologist
  • eval for lung transplant

clinical medicine II exam 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions