Restrictive Pulmonary Disorders

Question 1

The disease process is often chronic and can lead to irreversible
interstitial fibrosis causing derangement of gas exchange

Usually present with exertional dyspnea and dry cough of insidious
onset

Answer 1

Idiopathic Pulmonary Fibrosis

Question 2

What is the most common diagnosis in Interstitial lung diseases patients?

Answer 2

idiopathic pulmonary fibrosis

Question 3

CXR findings in this disease:

Ground-glass, nodular, or “hazy” appearance that may progress to
“honeycomb” lung

Answer 3

idiopathic pulmonary fibrosis

Question 4

“Velcro” crackles is a characteristic finding of what disease?

Answer 4

idiopathic pulmonary fibrosis

Question 5

What is the most common diagnosis presenting with interstitial lung disease?

Answer 5

Idiopathic Fibrosing Interstitial Pneumonia

Question 6

Multisystem disease of unknown etiology characterized by granulomatous inflammation

Inflammatory disease, chronic multisystem disorder: can affect lung, skin, eye, liver, lymph nodes

Answer 6

Sarcoidosis

Question 7

What location is the number one place for involvement in sarcoidosis?

Answer 7

Lung

Question 8

Sarcoidosis incidence highest in what demographic(s)?

Answer 8

North American blacks and northern European whites (Nordic) – Norway, Sweden, Denmark, Iceland, Finland

Question 9

What is the hallmark in sarcoidosis?

Answer 9

“Granuloma”

Question 10

In sarcoidosis, what percentage of patients present with pulmonary findings?

Answer 10

> 90%

Question 11

What are some extrapulmonary manifestations of sarcoidosis?

Answer 11

S – skin: erythema nodosum, lupus pernio
H – heart: conduction abnormalities
O – ocular: uveitis
P – parotid gland enlargement

Question 12

What enzyme is increased in 66% of sarcoidosis patients?

Answer 12

Angiotensin Converting Enzyme

Question 13

What test is a definitive diagnosis in sarcoidosis?

Answer 13

Biopsy via bronchoscopy or mediastinoscopy

Question 14

Noncaseating granulomas should have you suspect what disease?

Answer 14

sarcoidosis

Question 15

Sarcoidosis involvement where is associated with the worst prognosis?

Answer 15

Involvement of parenchyma

Question 16

Sarcoidosis involvement located solely here is associated with the best prognosis?

Answer 16

Outlook is best if only hilar adenopathy

Question 17

Chronic fibrotic lung diseases caused by inhalation of various dusts

Answer 17

Pneumoconiosis

Question 18

Clinically important pneumoconiosis include:

Answer 18

Asbestosis
Silicosis
Coal worker’s pneumoconiosis

Question 19

Which pneumoconiosis is described below?

usually rare by itself

Pleural plaques

Cigarette smoking accelerates disease and risk of lung CA

Associated with mesothelioma

Answer 19

Asbestosis

Question 20

Which pneumoconiosis is described below?

typically seen in construction workers

Prolonged inhalation of agent causes formation of small rounded opacities throughout lungs

Increased incidence of pulmonary TB (30x) and atypical mycobacterial disease – unsure why

Progressive pulmonary fibrosis

May be rapidly fatal in <2 years

Often presents 20 years after exposure

Answer 20

Silicosis

Question 21

Which pneumoconiosis is described below?

chronic fibrotic lung disease caused by inhalation of this worker’s exposure at work

coal dust is ingested by alveolar macrophages

Answer 21

Coal worker’s pneumoconiosis

Question 22

What is the oldest known occupational pulmonary disease?

Answer 22

Silicosis

Question 23

CXR findings in what disease?

“egg shell” calcification 🡪 very thin calcification
around the nodule

More commonly in upper lobes

Answer 23

Silicosis