interstitial lung disease

Question 1

causes upper zone fibrosis

Answer 1

CHARTS // coal workers // hypersensitivity (EEA) // ank spondy // radioation // TB // silicosis + sarcoid

Question 2

causes lower zone fibrosis

Answer 2

Idiopathic // SLE // drug induced // asbestosis

Question 3

common drugs causing fibrosis

Answer 3

amiodarone // bleomycin // methotrexate // nitrofurantoin // dopamine agonists

Question 4

who gets IPF

Answer 4

men 50-70

Question 5

features IPF

Answer 5

exertional SOB // bibasal fine end insp crepitations // dry cough // clubbing

Question 6

spirometry IPF

Answer 6

FEV1 normal // FVC decreased // FEV1/FEV1 increased

Question 7

gas exchange IPF

Answer 7

reduced transfer factor

Question 8

imaging IPF

Answer 8

CXR = ground glass or honeycombing // CT = gold standard

Question 9

what antibodies may be seen in IPF

Answer 9

ANA or RF

Question 10

mx IPF

Answer 10

rehab // O2 + transplant // poor prognosis 3-4 years

Question 11

how long does coal workers pneumoconiosis take to develop

Answer 11

15-20 years

Question 12

what is simple coal workers pneumoconiosis

Answer 12

most common + asymptomatic // may increase risk of COPD // can progress

Question 13

staging simple coal workers pneumoconiosis

Answer 13

cat 1 = some opacity but normal lung markings // cat 2 = large opacities + normal markings // cat 3 + large opacities + abnormal lung markings

Question 14

what is progressive massive fibrosis coal workers

Answer 14

round fibrotic masses in upper lobes // SOB on exertion + cough

Question 15

invx massive fibrosis coal workers

Answer 15

CXR = upper zine fibrosis // spirometry = mixed obstructive + restrictive eg normal or reduced FEV1 and reduced FVC

Question 16

what causes silicosis

Answer 16

fibrosis from inhaled silica eg mining, slate, foundy, pottery

Question 17

features silicosis

Answer 17

upper Zone fibrosis // egg shell calcification

Question 18

what infection are silicosis pts at risk of

Answer 18

TB

Question 19

range of lung disease from asbestos

Answer 19

plural plaques // pleural thickening // asbestosis // mesothelioma

Question 20

what are pleural plaques

Answer 20

common form of asbestos lung disease // benign with no metastatic potential

Question 21

what affects severity of asbestosis

Answer 21

length of exposure

Question 22

features asbestosis

Answer 22

SOB on exertion // clubbing // end insp crackles // restictive + reduced TCLO

Question 23

most common cancer assoc with asbestos

Answer 23

lung cancer

Question 24

features mesothelioma

Answer 24

progressive SOB, chest pain, pleural effusion, clubbing

Question 25

what type of malignancy is mesothelioma

Answer 25

pleural // right lung more common

Question 26

invx mesothelioma

Answer 26

CT // thoracoscopy

Question 27

mx mesothelioma

Answer 27

chemo +/- radio or surgery // 8-14 months

Question 28

what type of conditions is Extrinsic allergic alveolitis (EAA)

Answer 28

hypersensitivity type III

Question 29

types of EAA

Answer 29

bird fanciers // farmers // malt workers // mushroom workers

Question 30

presentation EAA

Answer 30

acute = SOB, dry cough, fever // chronic = lethargy, SOB, cough, anorexia + weight loss

Question 31

invx EAA

Answer 31

CXR = upper fibrosis // bronchoalveolar lavage = raised lymphocytes // IgG

Question 32

mx EAA

Answer 32

avoid triggers // oral steroids

Question 33

type of disease sarcoidosis

Answer 33

type IV sensitivity --> non-caseating granuloma

Question 34

who gets sarcoidosis

Answer 34

young black women

Question 35

assoc conditions sarcoidosis

Answer 35

Lofgens // mikulocz (parotid) // Heerfordts (parotid + fever)

Question 36

features sarcoidosis

Answer 36

erytheme nodosum // bilat hilar lymph // swinging fever // polyarthalgia // SOB // cough // malase // lupus // hyperCa!

Question 37

poor prognosis sarcoidosis

Answer 37

insidious onset >6months // NO erythema nodosum // extrapulm features // black // CXR stage III-IV

Question 38

bloods sarcoidosis

Answer 38

raised ACE + raised Ca

Question 39

CXR staging sarcoidosis

Answer 39

1 = bilateral hilar lymph (BHL) // 2 = BHL + infiltrates // 3 = diffuse intsertitial infiltrates only // 4 = diffuse fibrosis

Question 40

mx sarcodoisis

Answer 40

steroids

Question 41

indication mx sarcoidosis

Answer 41

CXR 2-3 AND symptomatic // hyperCa // eye, heart, neuro involvement