ILD Oct11 M2

Question 1

Idiopathic interstitial pneumonias, some diseases

Answer 1

• Usual interstitial P
• Nonspecific interstitial P
• Acute interstitial P
• Cryptogenic organizing P
• Desquamative interstitial P
• Lymphocytic interstitial P
• Respiratory bronchiolotis interstitial lung disease (RBILD)

Question 2

Why idiopathic interstitial pneumonias is a bad name (2)

Answer 2

• We know RBILD for ex is caused by cigarette smoking

- COP is in alveolar airspace and lumen or resp bronchioles

Question 3

Clinical counterpart of usual interstitial pneumonia (UIP)

Answer 3

idiopathic pulmonary fibrosis (IPF)

Question 4

pathological counterpart of nonspecific interstitial pneumonia (NSIP)

Answer 4

NSIP

Question 5

pathological counterpart of acute interstitial pneumonia (AIP)

Answer 5

diffuse alveolar damage

Question 6

pathological counterpart of cryptogenic organizing pneumonia (COP)

Answer 6

organizing pneumonia

Question 7

idiopathic pulmonary fibrosis (IPF) examples of symptoms

Answer 7

dyspnea, non productive cough, clubbing of fingers and toes

Question 8

IPF CT findings

Answer 8

thickened linear lines, prominent along pleura. Holes in the lines

Question 9

UIP macroscopic findings

Answer 9

honeycombing (wasp nest like spaces)

Question 10

UIP location

Answer 10

peripheral, subpleural

Question 11

what interstitium affected by UIP

Answer 11

parenchymal interstitium

Question 12

Most important pathologic feature of fibrosis

Answer 12

something activates fibroblasts to produce collagen

Question 13

UIP distribution and inflammation extent

Answer 13

patchy distribution (intra and interlobular severity)
Mild interstitial inflammation

Question 14

UIP progression of fibrosis and structural changes

Answer 14

biphasic fibrosis (on and off)
Architectural remodelling (honeycombing)

Question 15

how pleura and interlobular septa are affected in UIP

Answer 15

stay normal bc doesn’t affect non parenchymal IS

Question 16

UIP what happens to alveolar wall and airspaces as it becomes more severe

Answer 16

alveolar septum IS thickened by lymphocytes and collagen.

airspaces contain macrophages

Question 17

two phases of idiopathic pulmonary fibrosis (IPF) and which was easier to treat

Answer 17

Alveolitis (interstitial pneumonitis)
Fibrosis
Alveolitis easier to treat

Question 18

IPF prognosis

Answer 18

mean survival from onset is 5 years. few respond to steroids

Question 19

ILDs: how affect

compliance

Answer 19

decreased

Question 20

ILDs: how affect

elasticity and elastic recoil (elastance)

Answer 20

increased

Question 21

ILDs: how affect TLC, RV, VC

Answer 21

TLC decreased
RV same or little decreased
VC decreased

Question 22

ILDs: how affect diffusion capacity

Answer 22

decreased

Question 23

ILDs: how affect large airway caliber

Answer 23

unchanged or increased a little (scarring pulls them open in advanced disease)

Question 24

name for slight increase of large airway caliber in advanced ILD

Answer 24

bronchiectasis

Question 25

ILDs: how affect small airway caliber

Answer 25

decreased

Question 26

respiratory pattern of ILD (UIP included)

Answer 26

rapid and shallow breathing

Question 27

auscultation findings in ILDs (UIP included)

Answer 27

crepitations

Question 28

advanced ILD particular finding

Answer 28

cyanosis

Question 29

acute interstitial pneumonia (AIP) examples of symptoms

Answer 29

fever, fatigue, muscle aches, headaches, dyspnea,

Question 30

medical word for muscles aches

Answer 30

myalgia

Question 31

AIP (diffuse alveolar damage) macroscopic appearance

Answer 31

diffuse small holes in the lung

Question 32

Reason for small holes in the lung in AIP

Answer 32

branching bronchioles are empty and alveolar airspaces are filled with material and are consolidated. Same principle as air bronchogram

Question 33

High magnif: what we see in AIP (2) + name of phenomenon

Answer 33

alveolar septum contains neutrophils (shows IS pneumonitis) | pink eosinophilic material (fluid and protein and dead cells)

Question 34

UIP vs diffuse alveolar damage of AIP

Answer 34

UIP: lymphocytes and slow fibrosis AIP: toxic injury to endothelium and alveoli. leak of protein in airspace

Question 35

name of what we see on airway lining in AIP + name for the IS inflam _ protein leak in alveolar airspace

Answer 35

Hyaline membrane | Diffuse alveolar damage

Question 36

Cryptogenic organizing pneumonia (COP) examples of symptoms

Answer 36

productive cough, yellow sputum, low grade fever

Question 37

COP CXR findings + name for that

Answer 37

fluffy disease, airspace pattern. : Patchy airspace disease

Question 38

COP CT findings

Answer 38

fluffy disease, airspace pattern + AIR BRONCHOGRAM

Question 39

Organizing pneumonia: distribution and inflammation how and where

Answer 39

Patchy and varies within and between lobes | Mild IS inflammation

Question 40

Organizing pneumonia: where fibrosis happens (where fibroblasts are)

Answer 40

fibroblastic tissue in resp bronchioles, alveolar duct lumens and airspaces

Question 41

Why COP classified in IS pneumonitises if shows consolidation on CT

Answer 41

Bc often see interstitial pneumonitis with the disease (mild-moderate IS inflammation)

Question 42

Fibroblastic tissue similarity and difference in UIP vs COP

Answer 42

same fibroblastic tissue in both but is in alveolar airspace in COP

Question 43

how alveolar septa appear in COP on microscopy

Answer 43

thickened with lymphocytes: IS pneumonitis

Question 44

diffuse alveolar damage: what + seen in what disease

Answer 44

hyaline membrane lines airways, IS inflammation, alveolar airspace filled with protein and fluid