Pulmonary Fibrosis Flashcards
what are the chest x-ray findings in fibrosis?
- reticular shadowing of the lung peripheries - more prominent at the lung bases
- contours of the heart become less distinct
what are the causes of upper lobe fibrosis?
A TEA SHOP
A - allergic bronchopulmonary aspergillosis
T - tuberculosis
E - extrinsic allergic alveolitis
A - anylosing spondylitis
S - sarcoidosis
H - histiocytosis
O - occupational (silicosis, beryliosis)
P - pneumonconiosis (coal worker’s?
what are the causes of lower lobe fibrosis?
IPAS-BM
IP - infection, interstitial pneumonia
A - aspiration, alpha-1 antitrypsin deficiency, asbestosis
S - systemic sclerosis and other connective tissue disease (e.g. rheumatoid arthritis)
B - bronchiectasis
M - medications
what medications can lead to lower lobe fibrosis?
- busulfan
- bleomycin lung toxicity
- nitrofuratoin
- hydralazine
- methotrextate
- amiodarone
what does pulmonary fibrosis lead to?
interstitial lung damage and fibrosis
what is idiopathic pulmonary fibrosis?
chronic lung condition characterised by progressive fibrosis of the interstitium of the lungs with NO UNDERLYING CAUSE
what are the risk factors for idiopathic pulmonary fibrosis?
- 70 years old
- male
- smoker
what are the symptoms of pulmonary fibrosis?
- progressive exertional dyspnoea
- dry cough
- clubbing
what are the signs of idiopathic pulmonary fibrosis?
- cyanosis
- clubbing
- bibasal fine end-inspiratory crepitations
what are the complications of idiopathic pulmonary fibrosis?
- type 2 respiratory failure
- increased risk of lung cancer
- cor pulmonale
- 50% mortality in 5 years
what are the findings on chest x-ray in idiopathic pulmonary fibrosis?
bilateral lower zone reticulo-nodular shadowing
what are the findings on CT chest in idiopathic pulmonary fibrosis?
reticulonodular shadowing (ground glass appearance) and honeycomb lung
what are the spirometry findings in idiopathic pulmonary fibrosis?
restrictive picture
* FEV1 normal/decreased
* FVC decreased
* FEV1/FVC increased
impaired gas exchange - reduced transfer factor
what is the investigation of choice in idiopathic pulmonary fibrosis?
CT scan
ground glass –> honeycombing
what is the management of idiopathic pulmonary fibrosis?
- conservative = stop smoking, pulmonary rehabilitation
- medical = long-term oxygen, antifibrotic drugs
- surgical = lung transplant
what does this x-ray show?
sub-pleural reticular opacities that increase from the apex to the bases of the lungs
what does this CT demonstrate?
honeycombing
