Interstitial Lung Disease Mcphs

Front 1

Interstitial lung dz is also known as?

Back 1

pulmonary fibrosis and diffuse parenchymal lung dz

Front 2

What is the result of most ILD cases?

Back 2

scarring of lung tissue

Front 3

What are the main causes of ILD?

Back 3

inhaled substances, drug induced, connective tissue dz, infection, idiopathic, malignancy

Front 4

What drugs induce ILD?

Back 4

ABX, chemo drugs, antiarrhythmics

Front 5

What connective tissue dz cause ILD?

Back 5

systemic sclerosis, dermatomyositis, lupus, RA

Front 6

What infections cause ILD?

Back 6

atypical pneumonia, pneumocystis pneumonia, TB

Front 7

Idiopathic causes of ILD?

Back 7

sarcoidosis, idiopathic pulm fibrosis, hamman-rich syndrome

Front 8

Malignancy causes of ILD?

Back 8

lymphangitic carcinomatosis

Front 9

Inorganic substances that cause ILD?

Back 9

silicosis, asbestosis, berilliosis

Front 10

Organic substances that cause ILD?

Back 10

hypersensitivity pneumonitis

Front 11

What is the clinical presentation of ILD?

Back 11

progressive dyspnea on exertion, tachypnea, cyanosis, no wheezing, cough, hemoptysis, chest pain, other findings consistent w/ connective tissue dz

Front 12

Physical exam findings in ILD?

Back 12

crackles, rhonchi, cor pulmonale (mid to late stage), cyanosis (late stage), clubbing (late stage)

Front 13

Diagnostic test used for ILD?

Back 13

CxR, chest CT, PFTs, ABGs, exercise test, biopsy, bronchoalveolar lavage

Front 14

What are the PFT findings in ILD (restrictive disease)?

Back 14

decrease FEV1 & FVC, normal to increase FEV/FVC ratio, decreases in TLC, FRC, RV, and DLCO

Front 15

What are the ABG findings in ILD?

Back 15

may or may not have resting hypoxemia, exercise testing done w/ serial ABG

Front 16

When is lung biopsy performed in ILD?

Back 16

for differential Dx in pts over 50, w/ progressive course, rapidly worsening CxR, and atypical Sx

Front 17

Why is lung biopsy performed in ILD?

Back 17

assess disease activity, exclude neoplastic or infectious processes, identify treatable process, establish a definite Dx before potential harmful therapies are initiated

Front 18

What are the 2 different types of lung biopsy?

Back 18

transbronchial, surgical lung

Front 19

Which lung biopsy is the procedure of choice?

Back 19

tranbronchial

Front 20

What are the 3 types of pneumoconiosis?

Back 20

anthracosis (coal dust), silicosis, asbestosis

Front 21

Which type of pneumoconiosis is associated w/ miners, city dwellers and tobacco smokers?

Back 21

anthracosis

Front 22

What dz is associated w/ sand blasting, hard rock mining, & stone cutting?

Back 22

silicosis

Front 23

What dz is associated w/ ship builders, and construction and demolition?

Back 23

asbestosis

Front 24

Malignant mesothelioma is associated w/ what dz?

Back 24

asbestosis

Front 25

What are the Sx of malignant mesothelioma?

Back 25

CP, dyspnea, recurrent pleural effusions

Front 26

What are the preventive and Tx for pneumoconioses?

Back 26

limit exposure, smoking cessation, no Tx will halt progression, supportive Tx (bronchodilators, O2)

Front 27

What Dz is characterized by noncaseating granulomas involving many organs?

Back 27

sarcoidosis

Front 28

What are the symptoms of sarcoidosis?

Back 28

SOB, cough, CP, constitutional Sx, incidental finding on CxR

Front 29

How is sarcoidosis Dx?

Back 29

biopsy

Front 30

What is seen in stage I of sarcoidosis on CxR?

Back 30

hilar adenopathy

Front 31

What additional finding is there in stage 4 of sarcoidosis?

Back 31

hilar adenopathy plus lung fibrosis

Front 32

What is mainstay Tx for sarcoidosis?

Back 32

steroids (follow up w/ lunf fct and CxR)

Front 33

What are the Sx of idiopathic pulmonary fibrosis (IFP)?

Back 33

chronic, progressive SOB and cough

Front 34

CT findings in IFP?

Back 34

interstitial, reticular, peripheral abnormalities

Front 35

PFT findings in IFP?

Back 35

restrictive dz, decreased DLCO

Front 36

Tx for IFP?

Back 36

steroids (2-3 yr survival)

Front 37

What is Sx of desquamative interstitial pneumonitis (DIP)?

Back 37

chronic cough, dyspnea

Front 38

What is CxR findings in DIP?

Back 38

lower lobe ground glass infiltrates

Front 39

What is the histology of DIP?

Back 39

macrophages in airspaces w/ desquamation of septal epithelial cells and alveolar wall thickening

Front 40

What is the treatment for DIP?

Back 40

highly responsive to steroids

Front 41

What dz is abnormal hypersensitivity reaction to some inhaled antigen?

Back 41

hypersensitivity pneumonitis

Front 42

What are 4 examples of hypersensitivity pneumonitis?

Back 42

farmers lung, bird fancier’s lung, air conditioner lung/hot tubber’s lung, mushroom picker lung

Front 43

What are the symptoms of hypersensitivity pneumonitis?

Back 43

variable, cough, dyspnea, fever, leukocytosis

Front 44

What is histology of hypersensitivity pneumonitis?

Back 44

intersititial pneumonitis, fibrosis, many granulomas

Front 45

What is the Tx for chronic and acute Primary pulmonary eosinophilia (idiopathic)?

Back 45

steroids

Front 46

What Dz is a result of tropical microfilaria infection?

Back 46

secondary pulmonary eosinophilia

Front 47

What are the chronic causes of secondary pulmonary eosinophilia?

Back 47

parasitic, bacterial, fungal, drug allergies, asthma

Front 48

How is secondary pulmonary eosinophilia Tx?

Back 48

Tx underlying d/o

Front 49

What are the Sx of nonspecific intersititial pneumonitis (NSIP)?

Back 49

like IPF but at younger age, associated febrile illness

Front 50

What are the CT findings of NSIP?

Back 50

bilateral subpleural ground glass opacity and associated lower lobe volume loss

Front 51

What is the Tx for NSIP?

Back 51

steroids

Front 52

What is bronchiolitis abliteration-organizing pneumonia (BOOP)?

Back 52

common response to infection or inflammatory injury to lung

Front 53

What is CxR findings for BOOP?

Back 53

may appear like a mass

Front 54

What is the Tx for BOOP?

Back 54

steroids

Front 55

What are the Sx for Diffuse Pulm hemorrhage syndrome goodpasture’s dz?

Back 55

hemoptysis, simultaneous onset of glomerulonephritis and rapidly developing renal failure, CxR-patchy consolidations

Front 56

What is the Tx for diffuse pulm hemorrhage syndrome goodpasture’s dz?

Back 56

plasmophoresis, immunosuppression

Front 57

What are the pnuemonitis Dz associated w/ collagen vascular dzs?

Back 57

scleroderma, SLE, RA

Front 58

What drugs induce pneuomonitis?

Back 58

chemotherapeutics, amiodarone, dilantin

Front 59

What syndrome has shock lung, adult resp. failure and diffuse alveolar damage?

Back 59

adult respiratory distress syndrome (ARDS)

Front 60

What are the Sx of ARDS?

Back 60

rapid onset of life threatening resp insufficiency, dyspnea, cyanosis, and severe hypoxia to multi organs

Front 61

What triggers ARDS?

Back 61

catastrophic event 12-72 hrs prior

Front 62

What are the physical findings of ARDS?

Back 62

low PO2, elevated WBC, positive blood cx, low hemoglobin

Front 63

What are CxR findings of ARDS?

Back 63

diffuse bilateral infiltrates

Front 64

What dz has a sudden onset of dyspnea and severe hypoxemia due to pulmonary edema caused by increased permeability to the alveolar capillary bed?

Back 64

ARDS