Interstitial Lung Disease

Question 1

What is interstitial lung disease?

Answer 1

Many conditons that cause inflammation and fibrosis of the lung parynchyma

Question 2

Presentation of interstitial lung disease

Answer 2

• Shortness of breath on exertion
• Dry cough
• Fatigue

Question 3

Patients with Idiopathic pulmonary fibrosis have what typical findings on examination?

Answer 3

• Bibasal fine end-inspiratory crackles
• Finger clubbing

Remember this as classic OSCE station a stable and have good signs

COPD does not cause clubbing

Question 4

Diagnosis of interstitial lung disease involves?

Answer 4

• Clinical features
• High res CT scan of the thorax
• Spirometry- may be normal or show restrictive pattern

Question 5

> 50 year old patient presnets with insidious onset of shortness of breath and dry cough over more than 3 months. Diagnosis?

Answer 5

Idiopathic pulmonary fibrosis

Question 6

2

Medications availble to slow progression of idiopathic pulmonary fibrosis?

Answer 6

Pirfenidone- reduces firbosis and inflammation through various mechs

Nintedanib- reduces firbosis and inflamamtion by inhbiting tyrosine kinase

Question 7

4

Drugs that can cause secondary pulmonary fibrosis?

Answer 7

• Amiodarone- treat heart rhythm disorders
• Cyclophosphamide- treatment of neoplasms
• Methotrexate- treat rheumatoid arthritis
• Nitrofurantoin- antibiotic
• Bleomycin- chemo drug

Question 8

5

Pulmonary fibrosis can occur secondary to other conditons?

Answer 8

• Alpha-1 antitrypsin deficiency (made to protect lungs)
• Rheumatoid arthritis
• Systemic lupus erythematosus (SLE)
• Systemic sclerosis
• Sarcoidosis