Restrictive

Question 1

25 y/o African American M comes in c/o cough, and CP. PE shows maculopapular rash. Parotid gland enlargement. tender red nodules on anterior tib. What do you order?

Answer 1

1. CXR: bilateral hilar lymphadenopathy –>ground glass appearance
2. Tissue bx: Noncaseating granuloma with multinucleated giant cells
3. ACE increased

Question 2

Management of Sarcoidosis

Answer 2

Majority of patients have remission in 2 years w/o tx

Oral corticosteroids when needed

Question 3

Pt comes in with cough, SOB. Clubbing of fingers and inspiratory crackles. CXR shows honeycombing. Dx?

Answer 3

Pulmonary fibrosis-interstital scarring

Question 4

Pte comes in c/o of nonproductive cough with dyspnea. Reports working in mining 20 yrs prior.

Answer 4

Silicosis

CXR shows egg shell calcification of hilar and mediastinal nodes, nodular opacities in upper lobes

Question 5

Pt used to put insulation in houses. What part of lungs do you expect problem to be in?

Answer 5

Lower

Question 6

Chronic asbestos exposure can lead to…

Answer 6

1. Mesothelioma (bloody pleural effusions are common)

Tx: pleurectomy