Lung dz Flashcards
Pt. complains of shortness of breath and a dry cough. When you listen to his lungs you hear dry inspiratory velcro crackles over the base. CT shows ground glass appearance favoring the base, posterior, and periphery. Hisotology shown below. Tx?
Tx with Cyclophosphamide becuase pt. has NSIP pattern scleroderma lung
How do you distinguish NSIP from UIP in scleroderma lung?
NSIP has temporal homogeneity (all areas at same stage of dz)
How do you make the Dx of scleroderma lung?
Association of symptoms, signs and radiology of interstitial lung disease with skin, esophageal and renal manifestations of scleroderma and/or anti-Scl70 (anti-DNA topoisomerase) antibodies
30 yr old AAF comes in with pleuritic chest pain that she reports comes and goes. Pleural fluid tests positive for ANA. You get the biopsy shown below. Dx?
Lupus pleuritis (typically fibrinous pleuritis)
35 yr old AAF comes in with fever, cough, and shortness of breath. When you listen to he lungs you hear wet pulmonary crackles. CT shows diffuse ground glass opacification. Biopsy of lung tissue shown. Tx?
Steriods and immunosuppression because pt has acute lupus pneumonitis
You get an echocardiogram for your 29 yr old AAF pt. and discover she has pulmonary HTN. You get a biopsy and labs, which come back postive for ANA, Anti-dsDNA, and anti phospholipid Ab’s. Dx?
Thromboembolic pulmonary vascular disease with lupus
Your pt. comes in with dyspnea. You do an Xray and see small lungs. She has decreased diffusing capacity (DLCO) and restrictive pattern PFT abnormalities. How do you Tx her?
You don’t. She has shrinking lung syndrome with lupus and it’s usually self limited
30 yr old white male smoker complains of being short of breath when he climbs the stairs. You listen to his lungs and hear dry inspiratory velcro crackles. What underlying autoimmine dz does your pt. have?
RA
Dx?
UIP in RA pt
30 yr old RA patient who comes in with pulmonary complaints. CT shows peri-bronchial or centrilobular nodules and ground glass opacities in bronchocentric distribution. Tx?
Steroids b/c pt has follicular bronchiolitis
Your rheumatiod arthritis pt. presents with acute onset of fever and alveolar infiltrates. Tx?
Steroids. Pt has organizing pneumonia
Your rheumatiod arthritis pt. has Sjogren’s and obstructive pattern PFTs. Tx?
DO NOT give steroids. He didn’t tell us what to actually give. Pt has obliterative bronchiolitis(more common with RA)
What is this?
Rheumatoid nodule in lung
Pt. comes in with pulmonary HTN and cor pulomale. Biopsy shows no ILD. What autoimmune condition does this patient have?
Limited scelroderma: CREST syndrome
28 yr old white female pt complains of dyspnea and a relentless dry cough. Pt’s bronchials are hyperresposive. Dx?
Sjogren’s NSIP
