Restrictive Pulmonary Disease

Question 1

Ship building, insulation, demolition, and construction. Chest x-ray findings of interstitial fibrosis and pleural thickening

Answer 1

Asbestosis

Question 2

Coal mining, nodular opacities at upper lung fields Progressive massive fibrosis

Answer 2

coal workers lung

Question 3

Mining, sandblasting, stone or quarry work. Nodular opacities at upper lung fields Increased risk of tuberculosis and progression to massive fibrosis. Eggshell calcification of hilar lymph nodes

Answer 3

Silicosis (Silicosis = Egg Shell)

Question 4

High-tech fields, nuclear power, ceramics, foundries, aerospace, electrical plants. Diffuse infiltrates and hilar adenopathy. Requires chronic steroids

Answer 4

Berylliosis

Question 5

↑ ACE levels + Bilateral hilar adenopathy, non-caseating granulomas

Answer 5

Sarcoidosis

Question 6

Inspiratory crackles. Diffuse, patchy fibrosis with pleural honeycombing, reticular opacities

Answer 6

Idiopathic pulmonary fibrosis

Question 7

Which pneumoconiosis has diffuse infiltrates and hilar lymphadenopathy?

Answer 7

Berylliosis

Question 8

Which pneumoconiosis has nodular opacities in the upper lung fields on chest X-ray?

Answer 8

black lung from coal mining

Question 9

Which pneumoconiosis has egg shell calcification on chest X-ray?

Answer 9

silicosis

Question 10

Lofgren’s syndrome may present like sarcoid. What major difference separates these diseases?

Answer 10

Lofgren’s syndrome is short term and spontaneously resolves - Sarcoid is chronic

Question 11

What should be considered with a diffuse ground glass appearance and no pulmonary nodules on chest X-ray?

Answer 11

Infiltrative lung disease

Question 12

What is the Dx? Nuclear plant worker with shortness of breath?

Answer 12

Berylliosis

Question 13

What lab is elevated in sarcoidosis?

Answer 13

Angiotensin converting enzyme (4x higher than normal)

Elevated ESR

Question 14

Bilateral hilar adenopathy?

Answer 14

sarcoidosis

Question 15

What is the treatment for sarcoidosis?

Answer 15

steroids

Question 16

Class 5 pulmonary HTN cause?

Answer 16

sarcoidosis

Question 17

What cancer is a patient with asbestos exposure at increased risk for.

Answer 17

Mesothelioma

Question 18

What is the Dx? Patient worked with insulation. Chest X-ray shows thickened pleura and basilar lesions

Answer 18

asbestosis

Question 19

What is the Dx? Pulmonary fibrosis in a patient who was a sandblaster. Chest X-ray shows egg shell calcifications.

Answer 19

silicosis

Question 20

What is the Dx? Chronic dry cough dyspnea fatigue and clubbing. Chest X-ray shows fibrosis and CT chest shows honeycombing.

Answer 20

Idiopathic pulmonary fibrosis

Question 21

Does patient with sarcoidosis tend to have high or low serum calcium levels?

Answer 21

High (hypercalcemia)

Question 22

What is the Dx? Chest X-ray shows bilateral hilar adenopathy and non caseating granulomas?

Answer 22

sarcoidosis

Question 23

A 30 year old female presents with a dry cough. Her chest X-ray shows bilateral hilar adenopathy with non-caseating granulomas. What is your suspected diagnosis?

Answer 23

sarcoidosis