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72 Cards in this Set
- Front
- Back
|
how do you dx idiopathic pulmonary fibrosis on CXR?
|
widespread, BASE, bilateral
|
|
|
which ILD presents episodically?
chronic? |
hypersensitivity pneumonitis
silicosis, asbestosis |
|
|
For ILD, who is more likely to get it? men or women?
what's the exception? |
women; except in rheumatoid arthritis (which men get more often)
|
|
|
what determines the severity of disease
|
how much the TLC has reduced (it should be above 80%)
-if it's 70%, mild - if it's 50%, severe |
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|
what type of pattern will see on PFT for ILD?
|
restrictive pattern (decreased lung volumes, normal FEV1/FVC)
DLCO reduced secondary to physiological alveolar-capillary block (bc of interstitial problem) problem is that PFT does not help determine specific dz/etiology |
|
|
what is a key diagnostic tool that's superior to CXR for ILD?
|
high resolution CT
|
|
|
what are some causes of ILD (with fibrosis)?
|
known:
asbestos fumes, gases drugs radiation aspiration pneumonia ARDS unknown cause: SLE Rheumatoid arthritis |
|
|
silica will lead to what kind of ILD?
a. with fibrosis b. with granuloma |
B.
|
|
|
causes of ILD with granuloma
|
known:
hypersensitivity pneumonitis inorganic dust: silica unknown: sarcoidosis |
|
|
what is the characteristic pattern on CT for idiopathic pulmonary fibrosis?
|
honeycomb lung (patchy, subpleural, peripheral honeycomb pattern)
|
|
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IPF is a pathology of ____.
|
UIP (usual interstitial pneumonia)
- defined by heterogenous, asynchronous damage |
|
|
is IPF the same as hamman-rich syndrome?
|
no. hamman-rich syndrome (progressive fibrosis syndrome that's due to acute intersititial pneumonia, diffuse alveolar damage...rare, fulminant)
|
|
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condition that clinically look like IPF but have been going on for less than 3 months
|
hamman-rich syndrome
|
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T or F. with collagen vascular diseases associated with ILD, pleural involvement is more common than fibrosis.
|
T
|
|
|
what is the most common type pulmonary involvement in SLE?
|
pleuritis/pleural effusion
|
|
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what's the first thing you do if you suspect a pt has pleural effusion?
|
get a lateral decubitus CXR
|
|
|
what are the "2 unique issues" of rheumatoid arthritis with pleuropulmonary disease?
|
-pt will always have joint dz that happens before pulmonary involvement
- males>females (this is different from all the other interstitial lung dz's) |
|
|
Lung pt comes in with CXR that show patchy or diffuse infiltrates, often recurrent and migratory. On HRCT, reveals airspace ground glass opacitis (organizing pneumonia) and bronchial wall thickening/dilation with inflammation and granulation tissues (bronchiolitis obliterans)
|
Idiopathic “BOOP”: bronchiolitis obliterans organizing pneumonia
|
|
|
pt comes in asymptomatically. but CXR reveals lymph node involvement without parenchymal change
on biopsy, noncaseating granulomas are seen. dx? |
stage 1 sarcoidosis
|
|
|
how do you dx idiopathic pulmonary fibrosis on CXR?
|
widespread, BASE, bilateral
|
|
|
which ILD presents episodically?
chronic? |
hypersensitivity pneumonitis
silicosis, asbestosis |
|
|
For ILD, who is more likely to get it? men or women?
what's the exception? |
women; except in rheumatoid arthritis (which men get more often)
|
|
|
what determines the severity of disease
|
how much the TLC has reduced (it should be above 80%)
-if it's 70%, mild - if it's 50%, severe |
|
|
what type of pattern will see on PFT for ILD?
|
restrictive pattern (decreased lung volumes, normal FEV1/FVC)
DLCO reduced secondary to physiological alveolar-capillary block (bc of interstitial problem) problem is that PFT does not help determine specific dz/etiology |
|
|
what is a key diagnostic tool that's superior to CXR for ILD?
|
high resolution CT
|
|
|
what are some causes of ILD (with fibrosis)?
|
known:
asbestos fumes, gases drugs radiation aspiration pneumonia ARDS unknown cause: SLE Rheumatoid arthritis |
|
|
silica will lead to what kind of ILD?
a. with fibrosis b. with granuloma |
B.
|
|
|
causes of ILD with granuloma
|
known:
hypersensitivity pneumonitis inorganic dust: silica unknown: sarcoidosis |
|
|
what is the characteristic pattern on CT for idiopathic pulmonary fibrosis?
|
honeycomb lung (patchy, subpleural, peripheral honeycomb pattern)
|
|
|
how do you dx idiopathic pulmonary fibrosis on CXR?
|
widespread, BASE, bilateral
|
|
|
which ILD presents episodically?
chronic? |
hypersensitivity pneumonitis
silicosis, asbestosis |
|
|
For ILD, who is more likely to get it? men or women?
what's the exception? |
women; except in rheumatoid arthritis (which men get more often)
|
|
|
what determines the severity of disease
|
how much the TLC has reduced (it should be above 80%)
-if it's 70%, mild - if it's 50%, severe |
|
|
what type of pattern will see on PFT for ILD?
|
restrictive pattern (decreased lung volumes, normal FEV1/FVC)
DLCO reduced secondary to physiological alveolar-capillary block (bc of interstitial problem) problem is that PFT does not help determine specific dz/etiology |
|
|
what is a key diagnostic tool that's superior to CXR for ILD?
|
high resolution CT
|
|
|
what are some causes of ILD (with fibrosis)?
|
known:
asbestos fumes, gases drugs radiation aspiration pneumonia ARDS unknown cause: SLE Rheumatoid arthritis |
|
|
silica will lead to what kind of ILD?
a. with fibrosis b. with granuloma |
B.
|
|
|
causes of ILD with granuloma
|
known:
hypersensitivity pneumonitis inorganic dust: silica unknown: sarcoidosis |
|
|
what is the characteristic pattern on CT for idiopathic pulmonary fibrosis?
|
honeycomb lung (patchy, subpleural, peripheral honeycomb pattern)
|
|
|
IPF is a pathology of ____.
|
UIP (usual interstitial pneumonia)
- defined by heterogenous, asynchronous damage |
|
|
is IPF the same as hamman-rich syndrome?
|
no. hamman-rich syndrome (progressive fibrosis syndrome that's due to acute intersititial pneumonia, diffuse alveolar damage...rare, fulminant)
|
|
|
condition that clinically look like IPF but have been going on for less than 3 months
|
hamman-rich syndrome
|
|
|
T or F. with collagen vascular diseases associated with ILD, pleural involvement is more common than fibrosis.
|
T
|
|
|
what is the most common type pulmonary involvement in SLE?
|
pleuritis/pleural effusion
|
|
|
what's the first thing you do if you suspect a pt has pleural effusion?
|
get a lateral decubitus CXR
|
|
|
what are the "2 unique issues" of rheumatoid arthritis with pleuropulmonary disease?
|
-pt will always have joint dz that happens before pulmonary involvement
- males>females (this is different from all the other interstitial lung dz's) |
|
|
Lung pt comes in with CXR that show patchy or diffuse infiltrates, often recurrent and migratory. On HRCT, reveals airspace ground glass opacitis (organizing pneumonia) and bronchial wall thickening/dilation with inflammation and granulation tissues (bronchiolitis obliterans)
|
Idiopathic “BOOP”: bronchiolitis obliterans organizing pneumonia
|
|
|
pt comes in asymptomatically. but CXR reveals lymph node involvement without parenchymal change
on biopsy, noncaseating granulomas are seen. dx? |
stage 1 sarcoidosis
|
|
|
IPF is a pathology of ____.
|
UIP (usual interstitial pneumonia)
- defined by heterogenous, asynchronous damage |
|
|
is IPF the same as hamman-rich syndrome?
|
no. hamman-rich syndrome (progressive fibrosis syndrome that's due to acute intersititial pneumonia, diffuse alveolar damage...rare, fulminant)
|
|
|
condition that clinically look like IPF but have been going on for less than 3 months
|
hamman-rich syndrome
|
|
|
T or F. with collagen vascular diseases associated with ILD, pleural involvement is more common than fibrosis.
|
T
|
|
|
what is the most common type pulmonary involvement in SLE?
|
pleuritis/pleural effusion
|
|
|
what's the first thing you do if you suspect a pt has pleural effusion?
|
get a lateral decubitus CXR
|
|
|
what are the "2 unique issues" of rheumatoid arthritis with pleuropulmonary disease?
|
-pt will always have joint dz that happens before pulmonary involvement
- males>females (this is different from all the other interstitial lung dz's) |
|
|
Lung pt comes in with CXR that show patchy or diffuse infiltrates, often recurrent and migratory. On HRCT, reveals airspace ground glass opacitis (organizing pneumonia) and bronchial wall thickening/dilation with inflammation and granulation tissues (bronchiolitis obliterans)
|
Idiopathic “BOOP”: bronchiolitis obliterans organizing pneumonia
|
|
|
pt comes in asymptomatically. but CXR reveals lymph node involvement without parenchymal change
on biopsy, noncaseating granulomas are seen. dx? |
stage 1 sarcoidosis
|
|
|
what are the radiologic stages of sarcoidosis?
|
Stage 0: no CXR abnl (5-10%, i.e., sarcoid diagnosed in another organ system)
I lymph node enlargement without parenchymal change, most common* II nodes +, diffuse parenchymal changes III nodes -, diffuse changes IV evidence of fibrosis |
|
|
what are occupations associated with silicosis?
|
stone cutting/polishing, mining, foundry work, sandblasting (requires >5 years of exposure)
|
|
|
what are the characteristic x-ray findings of silicosis?
|
fibrotic dz in the upper lobes (apex)
hilar adenopathy |
|
|
50 y/o pt is a foundry worker who presents with dyspnea, productive cough. CXR reveals upper lobe fibrosis and hilar adenopathy.
dx? what disease is he at greater risk for? |
silicosis
TB |
|
|
mesothelioma is related to _____ exposure
|
asbestos
|
|
|
occupations associated with asbestosis
|
Shipyard workers of World War II
Refineries Demolition of old buildings Construction Insulation Brake Repair |
|
|
T or F. asbestosis is the fibrosis that can be seen on CXR on lower lung fields.
|
True
|
|
|
what's the classic CXR finding for asbestosis?
|
fibrosis in lower lung fields
|
|
|
is mesothelioma associated with smoking?
|
no!! just asbestos exposure
|
|
|
pt who works as a farmer presents with recurrent and episodic fevers.
CT over the course of a week, reveals diffuse processes in the lungs that are episodic. dx? |
hypersensitivity pneumonitis
antigenic response to organic dust (thermophlic actinomyces) |
|
|
What characteristic findings are present on pulmonary function testing in most cases of interstitial lung disease? How do these findings generally differ between different types of interstitial lung disease?
|
restrictive
they don't tell you difference in ILDs |
|
|
2. What types of imaging studies are most useful in the evaluation of interstitial lung diseases and how might findings help in your differential diagnosis?
|
start with CXR
diffuse - hypersensitivity pneumonitis upper lobe - silicosis base - asbestosis lymph node involvement - sarcoidosis then do HRCT to give you more information (like honeycomb lungs) |
|
|
Based on histopathologic findings, how are interstitial lung diseases often classified?
|
known causes (with fibrosis or granuloma formation) and unknown causes (with fibrosis or granuloma formation)
|
|
|
What are the most common physical exam findings and clinical symptoms for interstitial lung diseases and how do they usually differ between different etiologies?
|
PFTs are usually the same; sx's are usually the same; dyspnea, dry cough, fatigue; clubbing is potential; rales (crackles); exercise desaturation
chronic - silicosis, asbestosis episodic - hypersensitivity pneumonitis |
|
|
what is the most common epidemiology and clinical presentation of sarcoidosis?
|
epi = black females <40 y/o
presentation = asymptomatic with an abnormal CXR |
