ILD Flashcards
(20 cards)
What is diffuse parenchymal lung disease (DPLD)?
A group of >200 disorders affecting the lung interstitium, leading to inflammation and/or fibrosis and causing restrictive lung disease.
What is the most common idiopathic interstitial pneumonia?
Idiopathic pulmonary fibrosis (IPF).
What is the hallmark HRCT finding in idiopathic pulmonary fibrosis (IPF)?
Basal and peripheral honeycombing, traction bronchiectasis, and reticular opacities.
Which symptom is most common in patients with ILD?
Progressive dyspnea on exertion and a persistent dry cough.
What lung sounds are typically heard in ILD on auscultation?
Fine inspiratory crackles (“Velcro crackles”), often at the bases.
What autoimmune diseases are commonly associated with ILD?
Rheumatoid arthritis, systemic sclerosis, SLE, polymyositis, Sjogren’s syndrome.
What is the typical lung function pattern in ILD?
Restrictive: ↓TLC, ↓FVC, ↑FEV1/FVC ratio, and ↓DLCO.
Which two antifibrotic agents are approved for idiopathic pulmonary fibrosis?
Pirfenidone and Nintedanib.
What is hypersensitivity pneumonitis, and how is it triggered?
An allergic granulomatous reaction to inhaled organic antigens like bird droppings (bird fancier’s lung) or moldy hay (farmer’s lung).
Which imaging feature suggests hypersensitivity pneumonitis?
Ground-glass opacities, centrilobular nodules, and air-trapping on HRCT.
What distinguishes sarcoidosis from other ILDs on imaging?
Bilateral hilar lymphadenopathy, upper-lobe predominant infiltrates, and non-caseating granulomas on biopsy.
What are some drugs that can cause ILD?
Amiodarone, methotrexate, nitrofurantoin, bleomycin, busulfan.
What is the typical age of onset and prognosis of idiopathic pulmonary fibrosis?
Usually affects adults >50 years; poor prognosis with median survival ~3–5 years.
What is the role of BAL (bronchoalveolar lavage) in ILD?
Helps differentiate infection, malignancy, or specific cell types (e.g., lymphocytes in HP, eosinophils in eosinophilic pneumonia).
How does NSIP differ from IPF?
NSIP has a younger age of onset, better response to steroids, and more ground-glass opacities on HRCT.
Which ILD is most common in systemic sclerosis?
NSIP is more common than UIP (usual interstitial pneumonia).
What is the initial step in evaluating suspected ILD?
Detailed history (occupational, drug, systemic symptoms) + HRCT scan.
When is lung biopsy indicated in ILD?
When diagnosis remains uncertain despite imaging and serology, and will change management.
Which ILD has increased risk in young women and shows thin-walled lung cysts?
Lymphangioleiomyomatosis (LAM) – associated with tuberous sclerosis.
What supportive therapies are useful in ILD management?
Oxygen, smoking cessation, pulmonary rehab, vaccinations, and palliative care in advanced disease.
