SM 168 IIPs Flashcards
Where do all Interstitial Lung Diseases tend to effect the body?
Interstitial Lung Diseases primarily effect the interstitial space
Why are diffuse pulmonary metastases not considered Diffuse Pulmonary Lung Disease?
DPLD implies an unknown etiology, and cancer is a known etiology
What considerations help you make sure a suspected IIP is idiopathic?
Detailed history, physical exam, and connective tissue labs
What considerations rule out sarcoidosis in a suspected IIP?
Lack of: lymphadenopathy, upper-lobe nodules/fibroses, non-caseating granulomas, and multi-organ involvement
What considerations help you rule out eosinophilic disease in a suspected IIP?
Use a BAL to determine Eosinophil count
Does a prior history of DLPD support or rule out a diagnosis of IIP?
Support, and narrows down to AIP or COP
Does active smoking support or rule out a diagnosis of IIP?
Rule out?
What details are important in a history when considering a suspected IIP?
Pets, mold exposure, occupational exposures
What is the treatment for an elevated eosinophil count on a BAL?
Corticosteroid
What is AIP?
Acute Interstitial Pneumonia, an Idiopathic Interstitial Pneumonia (IIP)
How does AIP present?
AIP presents like ARDS, with acute hypoxemia, bilateral alveolar infiltrates and hyaline membranes, without a clear trigger
How is AIP differentiated from ARDS?
ARDS is due to a lack of surfactant, and is therefore not an IIP because it has a clear cause; AIP mimics ARDS but does not have a clear cause and is therefore an IIP
How does AIP show up on histology?
Like ARDS, it presents as Diffuse Alveolar Damage
How is AIP treated?
Supportive care primarily
What is COP?
Cryptogenic Organizing Pneumonia, an Idiopathic Interstitial Pneumonia (IIP), that presents with organizing pneumonia on histology
How does COP show up on histology?
COP presents as an organizing pneumonia
Why is a medication review important for IIP differential dx?
Medications like Amiodarone can cause lung damage = not an IIP
What basic lab work should be done to rule out IIP?
Connective tissue disease labs and hypersensitivity pneumonitis panel - if positive, not an IIP
What connective diseases are frequently screened for?
ANA = Lupus
Rheumatoid Arthritis
Myositis