Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Revision > Interstitial lung disease > Flashcards

Interstitial lung disease Flashcards

(76 cards)

Start Studying
1
Q

Where is the abnormality for:
1) Consolidation
2) Reticular
3) GGO

A

1) Air space
2) Interstitium
3) Either or both

Nb. if see GGO, see if dilated airways - if so then know fibrotic process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is honeycombing?

A

Clustered cystic airways in periphery
3-10mm (but can be larger)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is typical UIP?

A

Distribution: subpleural & basal (often heterogenous)
Features: reticulation + traction & honeycombing (& no features suggestive of alternative diagnosis)

Probable:
Dist: subpleural & basal (often heterogenous)
Feat: reticulation + traction & NO honeycombing (& no features suggestive of alternative diagnosis)

Indeterminate:
Dist: variable or diffuse
Feat: fibrosis but some features suggestive of non-UIP e.g. GGO, consolidatoin

Not-UIP:
Dist: upper/mid-lung/peribronchovascular predominant
Feat: Prominent consolidation/GGO (w/o acute exacerbation)/mosaic attenuation with sharply defined lobular air trapping on expiration/diffuse nodules or cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is definition of probable UIP?

A

Dist: subpleural & basal (often heterogenous)
Feat: reticulation + traction & NO honeycombing (& no features suggestive of alternative diagnosis)

Definite:
Distribution: subpleural & basal (often heterogenous)
Features: reticulation + traction & honeycombing (& no features suggestive of alternative diagnosis)

Indeterminate:
Dist: variable or diffuse
Feat: fibrosis but some features suggestive of non-UIP e.g. GGO, consolidatoin

Not-UIP:
Dist: upper/mid-lung/peribronchovascular predominant
Feat: Prominent consolidation/GGO (w/o acute exacerbation)/mosaic attenuation with sharply defined lobular air trapping on expiration/diffuse nodules or cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the definition of indeteminate UIP?

A

Dist: variable or diffuse
Feat: fibrosis but some features suggestive of non-UIP e.g. GGO, consolidatoin

Definite:
Distribution: subpleural & basal (often heterogenous)
Features: reticulation + traction & honeycombing (& no features suggestive of alternative diagnosis)

Probable:
Dist: subpleural & basal (often heterogenous)
Feat: reticulation + traction & NO honeycombing (& no features suggestive of alternative diagnosis)

Not-UIP:
Dist: upper/mid-lung/peribronchovascular predominant
Feat: Prominent consolidation/GGO (w/o acute exacerbation)/mosaic attenuation with sharply defined lobular air trapping on expiration/diffuse nodules or cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the defintion of not-UIP?

A

Not-UIP:
Dist: upper/mid-lung/peribronchovascular predominant
Feat: Prominent consolidation/GGO (w/o acute exacerbation)/mosaic attenuation with sharply defined lobular air trapping on expiration/diffuse nodules or cysts

Definite:
Distribution: subpleural & basal (often heterogenous)
Features: reticulation + traction & honeycombing (& no features suggestive of alternative diagnosis)

Probable:
Dist: subpleural & basal (often heterogenous)
Feat: reticulation + traction & NO honeycombing (& no features suggestive of alternative diagnosis)

Indeterminate:
Dist: variable or diffuse
Feat: fibrosis but some features suggestive of non-UIP e.g. GGO, consolidatoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CT shows mosaic attenuation. How can you tell if black or white lung abnormal?

A

Are there fewer/smaller vessels in black lung?
Y (black abnormal)
–> occlusive vascular disease e.g. CTEPH (look for dilation of central PA, RV/LV ratio, subpleural opacities/linear bands, effusions)
–> small airways disease e.g. obliterative bronchiolitis (look for large airway dilatation e.g. bronchiectasis - could ask for expiratory scan if unsure)

N (white abnormal)
–> infiltrative lung disease e.g. GGO

Nb. can have both abnormal - if fewer vessels in black & GGO/fibrosis in white
–> Hypersensitivity pneumonitis OR sarcoid

Nb2. if look similar then probably white lung abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are CT findings of NSIP?

A

Symmetrical, bilateral GGO
If fibrotic, fine reticulation and volume loss + traction
Bronchovascular, subpleural sparing nb. still often peripheral though
Can have cysts but not honeycombing

Nb. nodules, mosaic attenuation or cysts should make you think of other things

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What kinds of NSIP are there?

A

Fibrotic - worse outcome
Cellular

Causes: CTD, autoimmune, drug esp chemo, relapsing OP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are causes of NSIP?

A

CTD e.g. SLE/scleroderma/myositis
Autoimmune e.g. RA, PBC, antisynthetase
Drugs e.g. chemo
Relapsing OP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are causes of UIP?

A

IPF
CTD-ILD - RA common, systemic sclerosis (NSIP more common), poly/dermato (UIP/NISP/COP), mixed CTD (UIP/NSIP)
Chronic HP
Asbestosis
Radiation
ANCA vasculitis
Drugs - amidorone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is histology of UIP?

A
  • Dense fibrosis + architectural distortion (e.g. honeycombing)
  • Predominant subpleural/paraseptal fibrosis with areas of less involved parenchyma
  • Max mild inflammation only (and not lymphocytes >40% = HP)
  • Fibrobastic foci

HP
- Bronchocentric/diffuse interstitial inflammation with thickened alveolar septa
- Lymphocytes >40%, plasma cells +/- occasional multinucleate giant cells
- Poorly formed granuloma
- Tiny foci of OP (scattered plugs of fibroblasts)

Sarcoid
- Lymphatic distribution
- Non-necrotising granulomas
- Central areas of macrophages, epitheliod, multinucleate giant cells, CD4 T-cells
- Surrounded by CD4+8 Tcells, B cells, monocytes, mast cells & fibroblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the histology of HP?

A
  • Bronchocentric/diffuse interstitial inflammation with thickened alveolar septa
  • Lymphocytes >40%, plasma cells +/- occasional multinucleate giant cells
  • Poorly formed granuloma
  • Tiny foci of OP (scattered plugs of fibroblasts)

Nb.
UIP
- Dense fibrosis + architectural distortion (e.g. honeycombing)
- Predominant subpleural/paraseptal fibrosis with areas of less involved parenchyma
- Max mild inflammation only (and not lymphocytes >40% = HP)
- Fibrobastic foci

Sarcoid
- Lymphatic distribution
- Non-necrotising granulomas
- Central areas of macrophages, epitheliod, multinucleate giant cells, CD4 T-cells
- Surrounded by CD4+8 Tcells, B cells, monocytes, mast cells & fibroblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the histology of sarcoid?

A
  • Lymphatic distribution
  • Non-necrotising granulomas
  • Central areas of macrophages, epitheliod, multinucleate giant cells, CD4 T-cells
  • Surrounded by CD4+8 Tcells, B cells, monocytes, mast cells & fibroblasts

Nb.
UIP
- Dense fibrosis + architectural distortion (e.g. honeycombing)
- Predominant subpleural/paraseptal fibrosis with areas of less involved parenchyma
- Max mild inflammation only (and not lymphocytes >40% = HP)
- Fibrobastic foci

HP
- Bronchocentric/diffuse interstitial inflammation with thickened alveolar septa
- Lymphocytes >40%, plasma cells +/- occasional multinucleate giant cells
- Poorly formed granuloma
- Tiny foci of OP (scattered plugs of fibroblasts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are RFs for IPF?

A

Smoking, GORD, EBV, hep C, fhx of ILD
M>F
<50 years RARE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is IPF diagnosed?

A

Radiology MDT
- if not definite UIP, then can do lung biopsy (BAL not routinely recommended - main reason would be to r/o HP - lymphocytes >40%)

Histology:
- Dense fibrosis + architectural distortion (e.g. honeycombing)
- Predominant subpleural/paraseptal fibrosis with areas of less involved parenchyma
- Max mild inflammation only (and not lymphocytes >40% = HP)
- Fibrobastic foci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is biopsy taken for UIP and when is it needed?

A

Only needed if diagnostic uncertainty
Often risk > benefit
Recommend surgical biopsy (or cryobiopsy - 10% PNX, 10% haemorrhage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the main predictors of outcome for IPF?

A

Drop of SATS during 6MWT
TLCO at presentation (<40% = advanced disease)
Drop of FVC 10% or FEV1 15% in first 6-12 months
Overnight oximetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is most common mutation associated with IPF?

A

MUC5B (also ass with UIP with RA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is treatment for IPF?

A

Criteria: FVC 50-80% for pirfenidone or >50% for nintedanib+ MDT diagnosis
Stop if: FVC decline >10% in 1 year

Pirfenidone SEs. N, decrease appetite, photosensitive rash (30%)
Nintedanib SEs. D

Nb. slow decline in FVC by 50% (and nintedanib increases time to first exacerbation)

Monitor: LFTs at 1/12 for 6/12 then 3/12
- if 3-5xULN then reduce dose or stop but can return when normal (reduced dose and uptitrate)
- if >5ULN then stop (or <5 with symptoms of liver dysfunction)

Nb2. Can consider steroids if lots of GGO suggestive of exacerbation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are SEs of Pirfenidone? When can it be used and what do you have to monitor?

A

Nausea, decrease appetite, photosensitive rash (30%), wt loss

Indications: FVC 50-80% + MDT diagnosis of IPF –> start low dose and uptitrate
Stop if: FVC decline >10% in 1 year

Monitor: LFTs monthly for 6/12 then three-monthly
–> if 3-5xULN then decrease dose/interrupt and restart when normal
–> >5ULN then stop (or <5 but symptoms of liver dysfunction)

Suggest take with food due to SEs.
Approx 801mg TDS

Contraindications: pregnancy/breast feeding, smoking, eGFR<30, severe hepatic impairment
Caution: mild hepatic/renal impairment

Common interactions: ciprofloxacin (reduce does of pirfenidone and give high dose cipro 750mg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are SEs of Nintedanib? What are indications for use? What monitoring is required?

A

Diarrhoea, increased bleeding risk

Indications: FVC >50% + MDT diagnosis of IPF
OR progressive-fibrosing ILD and 10% FVC decline over 24months or 5-10% + symptoms
–> start at full dose (150mg BD)
Stop if: FVC decline >10% in 1 year

Monitor: LFTs monthly for 6/12 then three-monthly
–> if 3-5xULN then decrease dose/interrupt and restart when normal
–> >5ULN then stop (or <5 but symptoms of liver dysfunction)

Nb. only 1% renally excreted therefore can use in patients with very low renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is definition of progressive fibrotic ILD?

A

2/3 of:
- Worsening symptoms
- Radiological progression
- Physiological progression (decrease FVC ≥5% or DLCO ≥10% in 1 year)

All within 1 year in a patient with ILD that isn’t IPF and no other explanation for decline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What radiology patters do you see in CTD-ILD?

A

Chronic fibrosing: NSIP (SSc) or UIP (RA)

Subacute/acute: OP/NSIP/DAD (idiopathic inflammatory myositis)

Nb. if underlying disease quiescent, less likely to be this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the most common cause of CTD-ILD? What are the predictors of severity?
SSc - tends to present in more chronic way (NSIP) Severity: - Increased extent at presentation - Scl-70, Th/To, U3RNP - Short term progression in lung function - ILD in first 4 years of SSc diagnosis Nb. Anti-centromere Ab = protective (but ass with PH)
26
What is the typical radiological pattern for SSc-ILD?
NSIP - Symmetrical, bilateral GGO, fine reticulation and volume loss + traction, subpleural sparing nb. still often peripheral though
27
What is the typical radiological pattern for myositis-ILD?
OP/NSIP - particularly if subacute/chronic presentation Can get acute presentation. Has a good prognosis and CK levels may be normal.
28
What is the typical radiological pattern for RA-ILD? What are RFs?
NSIP but also UIP (NSIP more on radiology, but equal on histology) RFs: increasing age, smoking, male, anti-CCP
29
What is the prognosis for RA-ILD with UIP pattern?
Very like IPF nb. also ass with Muc5b
30
What is treatment for CTD-ILD?
General: Prednisolone 0.5-1mg/kg +/- iv/oral cyclophosphamide or azathioprine --> taper to maintenance <10mg Dermato/poly - early treatment with the above SSc - MMF --> use low dose steroids and cyclo if needed to get ression (only use low dose steroids due to risk of renal crisis) Nintedanib if progressive fibrosing (>10% fibrosis on CT)
31
What are the CT features of hypersensitivity pneumonitis?
Non-fibrotic pattern: - GGO/mosaic attenuation (suggest parenchymal infiltration) - Air trapping/ill-defined centirolobular nodules (suggest small airways disease) - Diffuse distribution +/- basal sparing Fibrotic: - reticulation/bronchiectasis/honeycomb (ie. fibrotic features) +/- centirolobular nodules, mosaic attenuation, 3-density pattern (ie. .small airways involvement) - Diffuse distribution +/- basal sparing Nb. BAL very helpful --> >30% lymphocytes (20% in non-smokers) +/- granulomas
32
How does HP present?
Very variable presentation and progression Squawks very helpful but not always present Nb. is a type 3 hypersensitivity mediated by IgG complexes
33
How is HP classified?
Fibrotic Non-fibrotic Nb. is a type 3 hypersensitivity mediated by IgG complexes
34
How is HP treated?
Avoid exposure (may be sufficient in mild disease) High dose steroids (0/5mg/kg 2-4 weeks) then taper MMF/azathioprine/Rituximab to maintain stability or if intolerant to pred Progressive fibrosing - Nintedanib
35
What are some common drug causes of HP?
Amiodarone, nitro, biologics Other causes: mould, gardening, hot tub (m.avium), farmers (fungi), bird proteins
36
What are histology features of HP?
Lymphocytosis on BAL (>20% or 30% in smokers) BUT may be normal if fibrotic HP Granulomas - 'ill defined' 'loose forming'
37
How do you define inflammatory non-fibrotic HP on CT?
1 of GGO/mosaic attenuation 1 or air trapping/ill-defined centirolobular nodules Dist: top>bottom Nb. Resp bronchiolitis in ILD tends to be centirolobular nodules in diffuse distribution Fibrotic: 1 of reticulation/bronchiectasis/honeyco 1 of centirolobular nodules/mosaic atten/3-density pattern Dist: top > bottom
38
How is HP diagnosed?
Clinical + CT + BAL +/- biopsy BAL: lympocytes >20% (30% smokers) >50% = highly suggestive May be normal in fibrotic HP. May see granulomas 'ill formed' 'loose forming'. May see giant cells with cholesterol clefts. Biopsy (transbronchial if non-fibrotic, transbronchial cryo or surgical if fibrotic): granulomatous, bronchocentric inflammation Nb. IgG against specific Ag marker of exposure, not disease. Helpful but not diagnostic.
39
What are RFs for mortality with HP?
UIP like pattern Increasing age Clubbing Higher severity disease Declining FVC Failure to identify trigger Intense exposure Smoker Short-telomeres
40
What causes a lymphocitic BAL? ie. >15%
Sarcoid NSIP HP (nb. >50% highly suggestive for this) Drug-induced pneumonitis Collagen vascular disorders Lymphocytic interstitial pneumonia Cryptogenic organising pneumonia Lymphoproliferative disorders Nb. >25% highly suggestive of granulomatous disease (sarcoid, HP, berylliosis) Nb2. Elevated CD4/CD8 ratio suggestive of sarcoid
41
What causes a neutrophilic BAL? ie. >3%
IPF Aspiration Collagen vascular disease Infection Asbestosis Bronchitis ARDS
42
What causes an eosinophilic BAL? ie. >1%
Eosinophilic pneumonias Drug-induced pneumonitis BM transplant Asthma, bronchitis Churg-Strauss ABPA Infection Hodgkins
43
What is the difference between a cyst and cavity on CT?
Cyst wall <2mm
44
CT shows bizarre-shaped cysts with thick walls. What is the diagnosis?
Langerhans cell histiocytosis - 20-30s - Strong ass with smoking (but not essential) - Upper & midzone bizarre shaped cysts with thick walls +/- nodules (become cysts) - Mixed obstructive/restrictive PFTs - Can be ass. with cysts in many places e.g. diabetes insipidus and bone cysts - Might see Bierbeek granules - CD1a positive cells on biopsy diagnostic Treat: smoking cessation/cladribine
45
CT shows uniform shaped but variable sized cysts throughout the lungs. What is the diagnosis?
Lymphangioleimyomatosis (LAM) - Female, often young - Lots of uniformly shaped (all spherical) but variable sized cysts with uniform distribution in lung. Can be large. - Mixed obstructive/restrictive PFTs - Ass with tuberous sclerosis (epilepsy, learning difficulties) and renal angiomyolipomas - Can get chylous effusion - Might see raised VEGF
46
Pt has basal predominant cysts on CT of irregular shapes. What is most likely diagnosis?
Burt-Hogg-Dube - Irregular shaped cysts (round and elongated), adjacent to interlobular septa, arteries and veins - Ass with skin folliculoma and renal cysts - Ass with FLCN gene mutation - Increased risk of renal and lung cancer Autosomal dominant
47
What causes nodules in: 1) perilymphatic distribution 2) random 3) centirolobular
1) Sarcoid, silicosis 2) Mets, TB, fungal 3) HP, ifx, bronchoalveolar ca, bronchiolitis
48
Pt has ill-defined centirolobar nodultes and scattered thin-walled cysts. What is most likely diagnosis?
Lymphocytic interstitial pneumonia - Female, >50 - Patchy GGO, cysts no zonal prediliction, varying sizes (might not be loads of cysts). Sometimes get calcified nodules associated with the cysts (amyloid deposits) - Ass with Sjogrens, HIV BAL lymphocytes Poly/monoclonal IgM gammopathy
49
What tracheobronchial abnormality is seen with granulomatosis with polyangitis?
Subglottic stenosis from granuloma (May see variable extrathoracic obstruction on flow volume loo)
50
What is a flow chart for lung cyst differential?
Mimic - bulla, cavity, bronchiectasis Single - pneumatocele, congenital foregut malformation, normal aging + Normal lung parenchyma —> LAM (smaller cysts but variable size, uniform distribution, ass with TS, young female) —> BHD (large lentiform/spherical cysts, lower zone/peripheral predominant) + nodules —> LCH (cavitatory nodules, upper zone predominant, bizarre shape, young smoker) —> LIP (middle age female, GGO, no zonal prediliction, variable size) —> amyloid + GGO —> PCP (perihilar GGO) —> LIP
51
What is definition of idiopathic pneumonitis with autoimmune features?
2/3 of: - Clinical extrathoracic feature of autoimmune disease e.g. Raynaud - Serologic (Ab) - Radiology or histology + not meeting criteria of CTD
52
What is treatment of LAM?
Siroliumus + transplant Avoid OCP. Young female, cysts all round but of varying size, uniform distribution, ass with tuberous sclerosis
53
What imaging should be done in pt with suspected sarcoid?
CXR +/- CT (may not need CT if typical findings and typical clinical picture) +/- CMR - if suspicions of cardiac sarcoid and abnormal ECG or echo Nb. should get ECG, & bloods incl calcium and LFTs annually. Regular lung function.
54
CT and clinical findings not sufficient to diagnose sarcoidosis. What is next test?
EBUS if LNs, otherwise TBBx
55
What treatment is needed for sarcoid?
Maybe none 10mg pred for longstanding and insiduously progressive disease - trial withdrawal after 6-12months 20-40mg for acute Can try inhaled steroid for cough 2nd line: methotrexate or azathioprine Also, leflunomide, infliximab, rituximab
56
What are sarcoid stages?
0 - normal CXR 1 - enlarged LNs 2 - enlarged LNs and parenchymal changes 3 - parenchymal changes w/o LNs or fibrosis 4 - fibrosis
57
What is Lofgren's syndrome?
Bilateral hilar lymphadenopathy, erythema nodosum +/- bilateral ankle arthritis
58
What is required to make a definitive diagnosis of sarcoid? When is it not needed?
Biopsy Not needed if Lofgren OR, long-standing pulmonary disease with typical clinical presentation and imaging + no obvious alternative
59
What might you see on biopsy in sarcoid? + BAL?
Biopsy - non-caeseating granulomas BAL - raised lymphocytes 15-25%, CD4:CD8 >4
60
How should fatigue be treated in sarcoid?
Trial prednisolone only if accompanying disease activity or all other options have been exhausted
61
How long should pt with sarcoid be followed up?
Can d/c with Lofgren or stage 1 CXR once resolution confirmed
62
What is the median survival after IPF diagnosis?
3 years Excerbation of IPF: median survival 3 months
63
What is Heerfordt-Waldenstrom syndrome?
Sarcoid + fever, parotid gland enlargement, facial nerve palsy and uveitis
64
What is Erasmus syndrome?
Progressive scleroderma in response to silica exposure
65
What is desquamative interstitial pneumonia?
Smoker Middle-age Male CT - diffuse, peripheral patchy GGO (i.e.non-specific) Bippsy - Pigment laden macrophages on biopsy
66
What factors are associated with IPF?
Age (rare in <60) Male Smoking Family history Cardiovascular disease & VTE Occupational - metal, wood, textiles, sand, stone, silica nb. approx 50% patients are clubbed
67
What factors are associated with poorer prognosis in fibrotic lung disease?
TLCO <40% at diagnosis Decrease FVC ≥10% over 6-12 months Decrease TLCO ≥15% over 6-12 months Desaturation on exercise to <88%
68
What is the mechanism of action of nintedanib?
Tyrosine kinase inhibitor
69
Radiological patterns of OP?
Multifocal peripheral OR peri-lobular OR bronchocentric consolidation Lymphocytic BAL nb. eosinophilic pneumonia classically has multifocal peripheral consolidation but will get high eosinophils (eosinophils of BAL >10%)
70
What is pulmonary haemosiderosis?
Iron deposition in lung e.g. ass with Goodpastures, idiopathic Small, ill-defined pulmonary nodules + calcification Lung parenchymal distortion Vignette will have haemorrhage
71
What are features of RB-ILD?
Need to be current smoker (can also get in RA and scleroderma) CT: peripheral bilateral GGO & centirolobular nodules. Can get cysts from fibrosis. Tend to also have emphysema. Pigement-laden macrophages on biopsy
72
What is Goodpasture's?
Anti-GBM disease (type 2 hypersensitivity with Ab adjacent type 4 collagen in renal glomerular basement membrane and cross-reactivity with alveolar membrane) Pulmonary haemorrhage + glomerulonephritis Radiology: bilateral GGO --> crazy paving +/- hilar lymphadenopathy
73
What is granulomatous lymphocytic interstitial pneumonia?
ILD seen in CVID Radiology: bilateral nodules, GGO, lymphadenopathy +/- interlobular septal thickening & bronchiectasis --> usually mid-lower lobe predominant Tx: rituximab
74
What is lymphangitis carcinomatosis?
Spread of tumour through lymphatics of lung - most commonly secondary to adenoca (breast > lung > stomach) CT: irregular and nodular interlobular septal thickening + pleural effusion
75
What is classic symptoms for granulomatosis with polyangiitis and how is it treated?
Triad of: - Upper resp tract involvement: hearing loss, gingivitis, oral ulcers, subglottic stenosis - Lower rep: nodules, infiltrates, cavities, pulmonary haemorrhage - Glomerulonephritis Treat - Life-threatening: plasma exchange, dialysis, immunosuppression - Organ-threatening: cyclophosphamide + glucocorticoid - Maintenance after remission: azathioprine or MMF
76
What are features of pulmonary alveolar proteinosis?
Crazy paving appearance Milky BAL anti-GM-CSF Ab diagnostic Tx: whole lung lavage

Revision (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions