ILD

Question 1

What is ILD?

Answer 1

Inflammation + scarring of Alveoli/Bronchioles.

Question 2

Investigating suspected ILD?

Answer 2

1) History + Examination
2) CXR - opacification
3) High Res CT - ‘ground glass’ grey opacity
4) Spirometry - Restrictive

Question 3

Distinguishing Examination signs of ILD?

Answer 3

3Cs: Cough, Clubbing + Coarse Crackles

Bilateral reduced chest expansion + breath sounds.

Question 4

Managing ILD?

Answer 4

1) Supportive (poor prognosis): O2 home therapy, flu + pneumococcal vaccine, palliative care planning.
2) Lung transplant - risk assess

Question 5

Types of ILD?

Answer 5

'I CHADS'
Idiopathic Pulmonary Fibrosis
Cryptogenic Organizing Pneumonia
Hypersensitivity Pneumonitis
Asbestosis 
Drug Induced
Secondary

Question 6

Patient >50: Dry Cough >3 months, Gradually worsening dyspnoea. No identifiable cause?

Answer 6

Idiopathic Pulmonary Fibrosis

Question 7

Allergic reaction, mast cells and lymphocytes on bronchoscopy?

Answer 7

Hypersensitivity Pneumonitis

Question 8

Local Inflammation, similar symptoms to pneumonia. Many triggers?

Answer 8

Cryptogenic Organising Pneumonia.

Question 9

Significant Occupational History, pleural plaques/thickening?

Answer 9

Asbestosis

Question 10

Causes of Drug induced Pulmonary Fibrosis?

Answer 10

MANC - Methotrexate, Amiodarone, Nitrofurantoin + Cyclophosphamide.