ILD

Question 1

clinical presentation of ILD

Answer 1

progressive DOE, NONPRODUCTIVE cough, NO wheezing and chest pain

Question 2

PE of ILD

Answer 2

crackles, inspiratory squeaks, cor pulmonale , cyanosis and clubbing (advance dz)

Question 3

CXR od ILD

Answer 3

1. ground glass (early)
2. reticular netlike /micronodular pattern
3. honeycombing (late)

Question 4

most common CXR finding in ILD

Answer 4

bilateral reticular netlike opacities

Question 5

pulmonary function test for ILD

Answer 5

restrictive defect

Question 6

restrictive defect

Answer 6

decreased TLC, decreased FEV1 and FVC, nl or increased FEV1/FVC ratio

Question 7

obstructive defect

Answer 7

increased TLC, nl FVC, decreased FEV1/FVC ratio

Question 8

DLCO

Answer 8

diffusing capacity (reduced in ILD)

Question 9

ABG

Answer 9

arterial blood gas (nl, hypoxemia, alkalosis in ILD)

Question 10

bronchoalveolar lavage

Answer 10

minor extension of bronchoscopy allows for cellular analysis

Question 11

gold standard for dx of ILD

Answer 11

lung biopsy

Question 12

types of lung biopsy

Answer 12

fibroptic bronchoscopy w/transbronchial lung biopsy, thoracoscopy, open lung

Question 13

complications of ILD

Answer 13

pulm HTN, cor pulmonale ( RVH), HF, Pneumothorax, CA

Question 14

most common cause of 2nd pneumothorax

Answer 14

ILD

Question 15

pneumoconiosis

Answer 15

any dz of the respiratory due to inhalation of dust particles

Question 16

asbestos are linked to

Answer 16

bronchogenic CA and malignant mesothelioma

Question 17

mesothelioma is always a/w

Answer 17

asbestos (most common in pleura)

Question 18

Asbestosis

Answer 18

gradual onset, DOE, inspiratory crackles, clubbing, dry cough

Question 19

CXR of asbestosis

Answer 19

opacities in lower lungs, thickened pleura, pleural plaques

Question 20

PFTs of asbestosis

Answer 20

restrictive pattern

Question 21

al asbestosis

Answer 21

Male, 50ish, pipefitter, smoker, pleural plaques

Question 22

lung damage is asbestosis is

Answer 22

irreversible

Question 23

asbestosis + smoking

Answer 23

lung CA x 59

Question 24

silicosis classification

Answer 24

chronic : simple or complicated

Question 25

chronic simple silicosis

Answer 25

hilar node calcification (eggshell pattern), small round opacities (silicotic nodules)

Question 26

chronic complicated silicosis

Answer 26

progresses after eliminated exposure : tachypnea and prolonged expiration

Question 27

Sam Silicosis

Answer 27

male, miner, indeterminate age, smoker, eggshell calcification

Question 28

sam silicosis has elevated risk of ?

Answer 28

TB

Question 29

sarcoidosis

Answer 29

multisystem inflammatory dz with unknown etiology

Question 30

noncaseating granulomas a/w

Answer 30

sarcoidosis

Question 31

PE of sarcoidosis

Answer 31

fever, anorexia, arthralgias, DOE, cough, erythema nodusum

Question 32

erythema nodusum a/w

Answer 32

sarcoidosis

Question 33

sarcoidosis PFTs

Answer 33

restrictive

Question 34

CXR of sarcoidosis

Answer 34

bilateral symmetric hilar and right paratracheal mediastinal adenopathy (most common pattern)

Question 35

sarcoidosis lab findings

Answer 35

hyperCa, high ESR, high serum protein, elevated ACE in 60%

Question 36

elevated serum ACE

Answer 36

sarcoidosis

Question 37

sally Sarcoidosis

Answer 37

female, african american, 30ish, non-smoker, hilar adenopathy, she is an ACE

Question 38

wegener's granulomatosis

Answer 38

immune mediated systemic vasculitis, glomeroulonephritis

Question 39

75% of these pt have renal involvement

Answer 39

wegener's granulomatosis

Question 40

rhinorrhea with purulent/bloody nasal discharge

Answer 40

wegener's granulomatosis

Question 41

PFT shows both obstructive and restrictive pattern

Answer 41

wegener's granulomatosis

Question 42

CT findings of wegener's granulomatosis

Answer 42

irregular and stellate-shaped peripheral pulmonary arteries (vasculitis sign)

Question 43

lab findings of wegener's granulomatosis

Answer 43

elevated ESR, leukocytosis, thrombocytosis, cormocytic anemia, elevated BUN/Cr, + ANCA

Question 44

positive ANCA a/w

Answer 44

wegener's granulomatosis

Question 45

Will wegener's granulomatosis

Answer 45

male or female, 40-50ish, upper airway symptoms √ the nose, goes to AA (+ANCA), vasculitis, renal

Question 46

most common of 7 idiopathic interstitial pneumonias

Answer 46

idiopathic pulmonary fibrosis (IPF)

Question 47

Dx of IPF

Answer 47

after excluding other causes of ILD

Question 48

digital clubbing is seen in 20-50% of

Answer 48

IPF

Question 49

CXR of IPF

Answer 49

bilateral diffuse reticular or reticulonodular infiltrates, periphery and bases

Question 50

patchy basilar infiltrates

Answer 50

HRCT of IPF

Question 51

PFTs of IPF

Answer 51

restrictive

Question 52

dx of IPF

Answer 52

lung biopsy

Question 53

Ivan IPF

Answer 53

male, 60ish, a common man, smoker

Question 54

most common indication for lung transplant

Answer 54

IPF