OnlineMedEd: Pulmonology - "DPLD"

Question 1

What is DPLD?

Answer 1

Diffuse Parenchymal Lung Disease

This is the new name for interstitial lung disease.

Question 2

Describe the typical presentation of DPLD?

Answer 2

• Chronic, insidious hypoxemic lung disease (years-long development of SOB)
• Dry cough
• Crackles on exam
• Restrictive lung pattern on PFTs

Question 3

VATS is _______________.

Answer 3

video-assisted thoracoscopic surgery

Question 4

The definitive diagnosis of DPLD is with _______________.

Answer 4

biopsy of the lungs through VATS

Question 5

Regardless of the etiology, the mainstay of treatment for DPLD is ______________.

Answer 5

steroids

Question 6

Give the diagnosis of DPLD based on time.

Answer 6

• Less than 6 weeks: acute interstitial pneumonitis (AIN)

* Greater than 6 weeks: idiopathic pulmonary fibrosis (IPF)

Question 7

List three rheumatologic conditions that can cause pulmonary fibrosis.

Answer 7

• Systemic lupus erythematosus
• Rheumatoid arthritis
• Systemic sclerosis

Question 8

Break down the categories of causes of DPLD.

Answer 8

• Drug-induced: bleomycin, amiodarone, radiation, methotrexate
• Rheumatologic: RA, SLE, and SS
• Primary: sarcoidosis
• Environmental: pneumoconiosis (coal, silicosis, berylliosis), hypersensitivity pneumonitis, asbestosis

Question 9

Cardiac sarcoidosis is diagnosed by _______________.

Answer 9

cardiac MRI (showing inflammation) followed by endocardial biopsy

Question 10

Why is hypersensitivity pneumonitis an important diagnosis to make?

Answer 10

It is antigen-mediated. The symptoms go away when the person is no longer exposed to the causative factor (barn dust, birds), so treatment is with removal of the agent.