Lecture 9 Interstitial Lung Disease Flashcards
Interstitial lung disease (ILD):
____ lung expansion causes _____ lung volumes; ie ____ FVC and TLC. What is the FEV1/FVC ratio?
reduced, reduced;
reduced;
greater than 80% (FEV doesn’t decrease as much as FVC)
most common cause of ILD
idiopathic pulmonary fibrosis (IPF) aka usual interstitial pneumonia (UIP)
different names for same thing
IPF is (reversible or irreversible); does it respond to treatment? Does stopping smoking help?
irreversible; not really, will need lung transplant;
no
IPF is characterized by an insidious ____ ____ that is disabling over time. the cough is (productive or nonproductive). seen in (older or younger patients?
exertional dyspnea, non productive; older
classic clinical picture of IPF: unilateral or bilateral crackles? Subpleural or pleural? apices or bases? characteristic \_\_\_\_\_ \_\_\_\_ abnormality
bilateral; subpleural bases honeycombing reticular
peripheral traction ____ may occur in IPF
bronchiectasis
what is the 6MWT?
6 minute walk test–monitors IPF progression
2 drugs that have shown promise in treating IPF
pirfenidone, nintedanib
nonspecific interstitial pneumonia (NSIP):
seen in ____ patients that smoke. there is tachypnea, crackles, but no ____ ____
younger; digital clubbing (as opposed to IPF)
NSIP shows a characteristic _____ finding on CT. It is typically __lateral and located in the ____ of the lungs
ground glass;
bi, base
Acute Interstitial Pneumonia (AIP)/Hamman-Rich causes _____ alveolar damage. it mainly affects ____ patients that ____. what is the prognosis?
diffuse, younger, smoke;
“bad”
respiratory bronchiolitis associated ILD (RB-ILD) is seen in patients with a history of ____ smoking. Patients are typically ____ and have (lot of symptoms or few symptoms?)
heavy, younger, few
RB-ILD is characterized by bibasilar end ____ ______ and diffuse centrilobar ____ opacities
inspiratory crepiations;
ground glass
Desquamative interstitial pneumonia is seen predominantly in _____ patients that _____. The course is characterized as _____ cough and dyspnea. What is the prognosis>?
younger, smoke;
insidious/subacute;
“better”
lymphocytic interstitial pneumonia (LIP) is characterized by monotonous sheets of ___ clonal lymphocytes. it is associated with what 2 diseases?
poly;
AIDS, sjogren’s
besides IPF, do all interstitial pneumonias improve with immunosuppression or smoking cessation?
you betcha
cryptogenic organizing pneumonia is characterized by bilateral air-space ____ or ground glass opacities. There is bronchial ___ thickening or _____ in abnormal areas. It has a good prognosis with _____.
consolidation; wall, dilatation;
steroids
acute vs chronic eosinophilic pneumonia:
which has eiosinophilia in the lungs? which has it in the blood?
which is more likely to relapse?
both, chronic in the blood;
chronic
sarcoidosis causes _____ granulomas. it causes bilateral enlargement of ____ lymph nodes. what classic skin finding is seen with it?
non-caseating; hilar (and mediastinal); erythema nodosum (on shins).
“lymphocytic distribution”
other symptoms of sarcoid in include ____, hyper____, and CNS involvement
uveitis, calcemia
histiocytosis X (langerhans) is a disorder characterized by accumulation of _____ ____ in various organs. causes ____ lesions on X ray with a ____ body in the cytoplasm of cells
mononuclear phagocytes;
cystic;
birbeck (X-body)
treatment of histiocytosis X:
stop smoking
classic triad of wegener’s granulomatosis: necrotizing ____, ____, and _____
what kind of anca is seen?
vasculitis, granulomas in the lung/upper airway, glomerulonephritis;
c-anca
large ____ densities, sometimes causing ____, are seen on CXR in patients with Wegener’s. treatment is what?
nodular, cavitations;
corticosteroids, cyclophosphamide
hypersensitivity pneumonitis: classically due to exposure of _____. BAL shows lavage fluid _____.
bird droppings/birds (allergen)
lymphocytosis
lymphangioleimyomatosis (LAM) is seen in ____ women that present with _____ or pneumothorax. what kind of lesions are seen in the lung?
young, dyspnea;
cystic
4 drugs listed in FA that can cause interstitial lung disease:
bleomycin, busulfan, amiodarone, methotrexate
what happens to diffusion capacity in patients with ILD?
its going down (it decreases)
which 2 general conditions can cause interstitial shadowing on a CXR? how do you differentiate between the 2?
cardiogenic pulmonary edema responds to lasix;
ILD does not
does ILD usually cause pleural effusion?
no
what condition causes pleural thickening>?
asbestosis
