Lung Fibrosis

Question 1

Lung fibrosis?

Answer 1

• It is important in the exam to be able to differentiate between conditions causing predominately upper or lower zone fibrosis.
• It should be noted that the more common causes (idiopathic pulmonary fibrosis, drugs) tend to affect the lower zones

Question 2

Fibrosis predominately affecting the upper zones?

Answer 2

• hypersensitivity pneumonitis (also known as extrinsic allergic alveolitis)
• coal worker’s pneumoconiosis/progressive massive fibrosis
• silicosis
• sarcoidosis
• ankylosing spondylitis (rare)
• histiocytosis
• tuberculosis

Question 3

Fibrosis predominately affecting the lower zones?

CT scan showing advanced pulmonary fibrosis including ‘honeycombing’

Answer 3

• idiopathic pulmonary fibrosis
• most connective tissue disorders (except ankylosing spondylitis)
• drug-induced: amiodarone, bleomycin, methotrexate
• asbestosis

Question 4

Mnemonic for Fibrosis predominantly affecting the upper lungs?

Answer 4

Fibrosis predominantly affecting the upper lungs:

HATCHSS

H ypersesitive pneumonitis (extrin allergic alveolitis)

A nkylosing spondylitis (rare)

C oal workers progressive pneumoconiosis

T uberculosis

S arcoidosis

S ilicosis

Question 5

Mnemonic for Fibrosis predominantly affecting the lower lungs?

Answer 5

Mnemonic for Fibrosis predominantly affecting the lower lungs:

MIDS

M ost connective tissue disorders

A sbestosis

I diopathic pulmonary fibrosis

D rug induced