ILD Flashcards
(20 cards)
What is ILD?
Interstitial lung disease
Causes inflammation and fibrosis of lung parenchyma
What are the presenting features of ILD? (3)
Sob on exertion
Dry cough
Fatigue
What are the typical signs of idiopathic pulmonary fibrosis? (2)
Bibasal fine end inspiratory crackles
Finger clubbing
What is used in diagnosis of ILD? (3)
Clinical features
High resolution ct scan - ground glass
Spirometry
What Spirometry pattern is seen in ILD?
Normal or restrictive
>0.7
What is the management of ILD? (7)
• Remove or treat the underlying cause
• Home oxygen where there is hypoxia
• Stop smoking
• Physiotherapy and pulmonary rehabilitation
• Pneumococcal and flu vaccine
• Advanced care planning and palliative care where appropriate
• Lung transplant is an option, but the risks and benefits need careful consideration
What is the presentation of idiopathic pulmonary fibrosis? (2)
Insidious sob
Dry cough over 3 months
What is the prognosis of idiopathic pulmonary fibrosis?
2-5 years
What 2 medications can slow progression of idiopathic pulmonary fibrosis?
• Pirfenidone reduces fibrosis and inflammation through various mechanisms
• Nintedanib reduces fibrosis and inflammation by inhibiting tyrosine kinase
How does nintedanib slow fibrosis?
Inhibits tyrosine kinase
What drugs can cause pulmonary fibrosis? (4)
Amiodarone
Cyclophosphamide
Methotrexate
Nitrofurantoin
What conditions can cause pulmonary fibrosis? (5)
○ Alpha-1 antitrypsin deficiency
○ Rheumatoid arthritis
○ Systemic lupus erythematosus (SLE)
○ Systemic sclerosis
○ Sarcoidosis
What test is performed to diagnose hypersensitivity pneumonitis? What is a positive result?
Broncheoalveolar lavage
Raised lymphocytes
What is hypersensitivity pneumonitis?
involves type III and type IV hypersensitivity reaction to an environmental allergen. Inhalation of allergens in patients sensitised to that allergen causes an immune response, leading to inflammation and damage to the lung tissue.
What is the management of hypersensitivity pneumonitis? (3)
Removing allergen
Oxygen
Steroid
What is cryptogenic organising pneumonia?
It involves a focal area of inflammation of the lung tissue. It can be idiopathic or triggered by infection, inflammatory disorders, medications, radiation, environmental toxins, or allergens.
What is the presentation of cryptogenic organising pneumonia? (5)
Similar to infectious pneumonia
Sob
Cough
Fever
Lethargy
Inspiratory crackles
What is the definitive investigation in cryptogenic organising pneumonia?
Lung biopsy
What is the treatment of cryptogenic organising pneumonia?
Systemic corticosteroids
What can asbestos inhalation cause? (4)
Lung fibrosis (asbestosis)
Pleural thickening and pleural plaques
Adenocarcinoma
Mesothelioma
