Restrictive Lung Disease

Question 1

Nodule of WBCs formed as a reaction to infections, inflammation, irritants, or foreign bodies.

Answer 1

Granuloma

Question 2

Air containing space within a pulmonary infiltrate or mass.

Answer 2

Cavitation

Question 3

Space between the air sacs and the small blood vessels that surround the air sacs.

Answer 3

Interstitium

Question 4

What is the standard for diagnosis of diffuse interstitial lung disease?

Answer 4

Surgical Lung Biopsy

Question 5

Systemic inflammatory disease of unknown etiology that manifests as non-caseating granuloma in the lungs and intrathoracic lymph nodes.

Answer 5

Sarcoidosis

Question 6

What types of cells are having an exaggerated response in patients with Sarcoidosis?

Answer 6

T-Cells

Question 7

Who does Sarcoidosis most commonly present in?

Answer 7

African American
Females

Question 8

How does Sarcoidosis present when it does have symptoms?

Answer 8

Erythema nodosum
Lupus pernio
Bilateral hilar lymphadenopathy

Question 9

How is Sarcoidosis diagnosed?

Answer 9

Biopsy → Non-caseating granuloma

Question 10

How is Sarcoidosis treated?

Answer 10

Prednisone (Oral)
20 - 40 mg

Question 11

How is Sarcoidosis treated in a patient that cannot tolerate corticosteroids?

Answer 11

Methotrexate
(Immunosuppressive)

Question 12

Radiograph Stage 1 Sarcoidosis

Answer 12

Bilateral Hilary Lymphadenopathy (Alone)

Question 13

Radiograph Stage 2 Sarcoidosis

Answer 13

Hilar Lymphadenopathy + Parenchymal Involvement

Question 14

Radiograph Stage 3 Sarcoidosis

Answer 14

Parenchymal Involvement (Alone)

Question 15

Radiograph Stage 4 Sarcoidosis

Answer 15

Fibrotic changes in the Upper Lobes

Question 16

What can be useful for monitoring patients with Sarcoidosis and what might you expect to see?

Answer 16

Bronchoalveolar Lavage + increased lymphocytes and a high CD4/CD8 cell ratio

Question 17

Idiopathic disease typically occurring in patients older than 65 and who have inspiratory crackles.

Answer 17

Idiopathic Pulmonary Fibrosis

Question 18

What are findings you’d see in a patient with Idiopathic Pulmonary Fibrosis?

Answer 18

Dilated Bronchiectasis
Reticulation
Honeycombing

Question 19

What is the only definitive treatment for a patient with Idiopathic Pulmonary Fibrosis?

Answer 19

Lung Transplant

Question 20

What can be given to a patient with Idiopathic Pulmonary Fibrosis to reduce the rate of decline of their lung function, but does not improve survival or quality of life?

Answer 20

Nintedanib

Question 21

Pneumoconioses that is caused by alveolar macrophages leading to the formation of macules.

Answer 21

Coal Worker’s Lung

Question 22

What would you expect to see on a chest X-Ray of a person with Coal Worker’s lungs?

Answer 22

Diffuse + Small Opacities
(Upper Lungs)

Question 23

Caused by prolonged or extensive inhalation of silica particles?

Answer 23

Silicosis

Question 24

What occupations are at greatest risk of Silicosis?

Answer 24

Construction
Mining

Question 25

What does Silicosis look like on chest X-Ray?

Answer 25

Small Rounded Opacities

Question 26

What is a radiograph finding that strongly suggests Silicosis?

Answer 26

Eggshell Calcifications (Calcification of periphery hilar lymph nodes)

Question 27

Patients with Silicosis have an increased incidence of what?

Answer 27

Pulmonary Tuberculosis (PPD Skin Test)

Question 28

Nodular interstitial fibrosis occurring in specific types of workers.

Answer 28

Asbestosis

Question 29

Occupations that are more at risk for Asbestosis

Answer 29

Shipyard Construction Pipe Fitters Insulators

Question 30

What do you see on a X-Ray of a patient with Asbestosis?

Answer 30

Linear Streaking at Lung Base

Question 31

What is the best test to detect Asbestosis?

Answer 31

CT Scan

Question 32

Pathology caused by aerosolized exposure and sensitivity to organic antigens such as: - Agricultural Dusts - Bioaerosols of Microorganisms

Answer 32

Hypersensitivity Pneumonitis

Question 33

Can Hypersensitivity Pneumonitis be reversed?

Answer 33

Yes Prompt diagnosis and removal of antigen

Question 34

How is Severe or Progressive Hypersensitivity Pneumonitis treated?

Answer 34

Oral Corticosteroids