SG 31 Pulm Diseases

Question 1

CXR + CT pulm fibrosis findings

Answer 1

Reticular pattern
Traction bronchiectasis
Honeycomb cysts

Question 2

Pulm fibrosis PFTs

Answer 2

Restrictive + severely decrease DLco

Question 3

Histo for pulm fibrosis

Answer 3

Histo pattern for pulm fibrosis = UIP
Honeycomb cysts = enlarged air spaces
Fibroblastic foci

Question 4

Effective treatments for pulm fibrosis

Answer 4

Lung transplant

Question 5

What other diffuse lung diseases would present in similar pattern to pulm fibrosis?

Answer 5

Occupational pneumoconioses
HST pneumonitis
Rxn to medications

Question 6

Histo findings for OP

Answer 6

Patchy not uniformly diffuse areas of organization

Vs organizing DAD which looks the same but is throughout the lungs

Question 7

Treat OP

Answer 7

Corticosteroids

If fail, might escalate to immunosuppressants

Question 8

If histo shows non-necrotizing granulomas in perihilar masses, what are you thinking of?

Answer 8

Sarcoid

Question 9

Treat sarcoid

Answer 9

CS

Question 10

2 majors types of diseases that cause crackles + progressive SOB

Answer 10

1. Fibrotic lung disease - IPF, NSIP, HP, sarcoid, silicosis

2. Pulm edema - CHF, renail failure

Question 11

If a pt reports history of sand blasting, what are you worried about? Why is sand blasting in particular so bad for you lungs?

Answer 11

Silicosis
Silica is most reactive with freshly fractured like in sand blasting
Expose tetrahedral shape -> greater fibrogenicity

Question 12

Silicosis CT

Answer 12

Nodules bilaterally

Upper > lower lobes

Question 13

If a pts has been exposed for 5 yrs silica, what kind of silicosis does he have?

Answer 13

Accelerated - onset between 5-10 yrs after exposure
OR
Acute silicosis - within 5 yrs of exposure

Question 14

What could accelerated silicosis progress to?

Answer 14

Complicated silicosis = progressive massive fibrosis = end stage