Restrictive Lung Diseases/Malignancy

Question 1

What happens with Interstitial Lung Diseases?

Answer 1

The lungs become scarred and stiff with loss of compliance

Question 2

What is a drug that can cause Interstitial Lung Disease?

Answer 2

Amiodarone

Question 3

What will the Total Lung Capacity be with Interstitial Lung diseases?

Answer 3

LOW

Question 4

What will the FEV1/FVC ratio be with Interstitial lung diseases?

Answer 4

Normal or HIGH

Question 5

What will the Diffusion capacity of the lung for CO be with Interstitial Lung diseases?

Answer 5

LOW

Question 6

What is a buzz word on a CT that should make you consider an Interstitial Lung Disease?

Answer 6

Honeycombing

Question 7

What is the best diagnostic test for Interstitial Lung diseases?

Answer 7

Biopsy

Question 8

What is the most common Interstitial Lung Disease?

Answer 8

Idiopathic Pulmonary Fibrosis

Question 9

Sarcoidosis is an autoimmune multi-organ disease. What is a classic finding on CXR?

Answer 9

Hilar LAD

Question 10

What will be found on biopsy with Sarcoidosis?

Answer 10

NON-caseating granulomas

Question 11

Sarcoidosis is associated with what lab changes (2)?

Answer 11

HIGH calcium and ACE levels

Question 12

What workers are at an associated with for Silicosis? What do the inhale and where does it go?

Answer 12

Stonecutters and quarry workers
– Silica dust –> UPPER LUNG ZONES

Question 13

What lung zones are affected with Silicosis?

Answer 13

Upper lung zones

Question 14

What 2 findings are characteristic of Silicosis on imaging?

Answer 14

Upper lung nodules
Hilar CALCIFICATIONS

Question 15

What 2 imaging findings are characteristic of Silicosis on imaging?

Answer 15

Upper lung nodules
Hilar CALCIFICATIONS

Question 16

What types of workers are exposed to Asbestosis?

Answer 16

Shipyards and construction

Question 17

What is the most common malignancy associated with Asbestosis exposure? More rare one?

Answer 17

Common = Bronchogenic Carcinoma
Rare = Mesothelioma

Question 18

What are a few exam findings consistent with Asbestosis?

Answer 18

Digital clubbing
End-inspiratory crackles

Question 19

What will be seen on CXR with Asbestosis exposure?

Answer 19

Peripheral pleural plaques

Question 20

What will be seen on CXR with Asbestosis?

Answer 20

Peripheral pleural plaques

Question 21

What will be seen on biopsy with Asbestosis exposure?

Answer 21

Ferruginous barbell bodies

Question 22

For lung cancers, following a CXR/CT, what test is done for peripheral lesions?

Answer 22

FNA

Question 23

For lung cancers, following a CXR/CT, what test is done for central lesions?

Answer 23

Bronchoscopy

Question 24

Which lung cancers are centrally located?

Answer 24

Small cell
Squamous cell

Question 25

Which lung cancer is peripherally located?

Answer 25

Adenocarcinoma

Question 26

What are 3 paraneoplastic syndromes associated with Small Cell?

Answer 26

SIADH
Cushing’s – ACTH
Lambert Eaton – antibodies to presynaptic Ca+

Question 27

What is the treatment for Small Cell?

Answer 27

Chemo and radiation

Question 28

What paraneoplastic syndrome is associated with Squamous cell?

Answer 28

Hypercalcemia from PTH-rP

Question 29

Which cancers are associated with smoke and which is not?

Answer 29

Smoking – Small cell/Squamous
NOT smoking – Adenocarcinoma

Question 30

If a patient presents with unilateral miosis/ptosis/anhidrosis, SVC engorgement with facial edema or hoarseness and arm pain…. what is the tumor?

Answer 30

Superior Sulcus (pancoast) tumor