Interstitial and Occupational Lung Diseases

Question 1

what is sarcoidosis?

Answer 1

type IV hypersensitivity reaction

granulomatous disease of unknown cause

Question 2

what systems are commonly involved in sarcoidosis?

Answer 2

lungs
lymphatics
joints
liver
skin 
eyes

Question 3

is sarcoidosis more or less common in smokers?

Answer 3

less

Question 4

how does acute sarcoidosis present?

Answer 4

erythema nodosum
bilateral hilar lymphadenopathy
arthritis
uveitis 
fever

Question 5

how does chronic sarcoidosis present?

Answer 5

lung + skin infiltrates
peripheral lymphadenopathy
hypercalcaemia

Question 6

what investigations are done for sarcoidosis?

Answer 6

CXR
tissue biopsy
PFTs - restrictive defect
bloods

Question 7

what abnormal blood results are seen in sarcoidosis?

Answer 7

raised calcium

raised inflammatory markers

Question 8

what blood level can be used as an activity marker in sarcoidosis?

Answer 8

ACE levels

Question 9

how is acute sarcoidosis managed?

Answer 9

self limiting

usually no treatment

Question 10

how is chronic sarcoidosis managed?

Answer 10

oral steroids

may need immunosuppression

Question 11

what follow up should be done for sarcoidosis?

Answer 11

CXr + PFT monitoring for several years

Question 12

what is another name for extrinsic allergic alveolitis?

Answer 12

hypersensitivity pneumonitis

Question 13

what is hypersensitivity pneumonitis?

Answer 13

a type III hypersensitivity reaction to an antigen, resulting in lymphocytic alveolitis

Question 14

how does acute hypersensitivity pneumonitis present?

Answer 14

coigh
breathlessness
fever
myalgia

Question 15

what does CXR show in acute hypersensitivity pneumonitis?

Answer 15

widespread pulmonary infiltrates

Question 16

how is acute hypersensitivity pneumonitis manages?

Answer 16

oxygen
steroids
antigen avoidance

Question 17

name two anti fibrotics

Answer 17

pirfenidone

nintedanib

Question 18

how does chronic hypersensitivity pneumonitis present?

Answer 18

progressive breathlessness and cough

Question 19

what is seen on CXR in chronic hypersensitivity pneumonitis?

Answer 19

pulmonary fibross

Question 20

how is chronic hypersensitivity pneumonitis managed?

Answer 20

remove exposure

oral steroids if breathless

Question 21

what is the most common interstitial lung disease?

Answer 21

idiopathic pulmonary fibrosis

Question 22

how does idiopathic pulmonary fibrosis present?

Answer 22

progressive breathlessness and dry cough

Question 23

what may be seen on examination in idiopathic pulmonary fibrosis?

Answer 23

clubbing

bilateral fine inspiratory crackles

Question 24

what investigations are done for idiopathic pulmonary fibrosis?

Answer 24

PFTs
CXR
CT

Question 25

how is idiopathic pulmonary fibrosis managed?

Answer 25

anti-fibrotics to slow profression oxygen as needed lung transplant in young