Interstitial lung disease Flashcards Preview

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Flashcards in Interstitial lung disease Deck (32):
1

2 genreal types of ILD

1. upper lobe
2. lower lobe

2

DDX for upper (5)

FASST
Farmer's lung (hypersensitivity)
Ank spond
Silicosis
Sarcoidosis
TB

3

what is farmer's lung (HP)

- from repeated exposures
- type 3 or 4 hypersens
- can be weeks to years

4

**4 general causes of HP and their subtypes to know

1. microbial
- farmer - thermophillic
- tobacco - asperilligus
- hot tub - mycobacterium avium
2. animal protein
- bird fancier
- also comforters
3. LMW chems
- isocyanates
- popcorn lung - butter flavor
4. meds

5

what is presentation of HP

- can be non-specific, but should be temporally related
- resp Sx
- constitutional Sx

6

3 timeframes of HP

acute - 4-6hrs
subacute - wks/months
chronic - long term with progressive fibrosis

7

5 things for HP Dx

1. exposure to antigen causes HP
2. clinical syndrome consitent with HP
3. PFT abnormalities - obs, rest, or both with low DLCO
4. radiographic abnormalities
5. supportive cyto/pathology

8

2 Tx of HP

1. removal of pathogen
2. immunosupression

9

what is silicosis

- occupational exposure to silical dust
- variable Sx

10

what is silicosis PFT

restriciton with low DLCO

11

imaging in silicosis

upper lobes nodules and calcificatiokns

12

what is sarcoidosis

inflammation rxn of non-caseating granulomatous inflammation
- cuase unknown
- can be anywhere in body, but 90% have lung

13

4 different presentation of sarcoidosis

1. incidental findings (stage 1)
2. resp Sx (stage 2,3,4
3. loffgrens (subtype of 1)
4. extra-pulmonary Sx

14

what is staging in sracoidosis

based on radiographic features
1. incidental findings of hilar adenopathy
2. hilar adenopathy and upper lobe nodules
3. upper lobe ILD with fibrosis
4. end stage fibrosis of the upper lobes

15

what are chances of spontaneous remission

1. 70-90%
2. 50-70
3. 10-30
4. 0

16

what is lofgrens

- subgroup of stage 1
- hilar adenopathy
- fever
- polyarthralgias/arthrirtis
- erythemia nososum

17

4 extrapulm. presentations of sarcoidosis

1. skin lesions
2. ocular
3. Ca metabolism
4. cardiac - conduction Sx

18

4 parts of sarcoidosis Dx

1. CXR show abnormalities
2. may or may not have Sx
3. PFT - obs or rest with low DLCO
4. path - granulomatous inflammation

19

Tx of sarcoidosis

1-2 - nothing
3-4 prednisone

20

DDx for lower lobe ILD (6)

RAAIDS
Rhem arth
Asbestosis
Aspirations
Idiopathic pulm fibrosis
Drugs
Scleroderma

21

what is connective tissue ILD

most rheumatic conditions can cause ILD
- leading cause of death in rheumatic conditons

22

2 rheumo conditions

1. RA - uncommon manifestation of common dis
2. scleroderma - common manif. of uncommon disease

23

2 things for diagnosis of CT-ILD

Hx and Phx
serology

24

what is asbestsis

- occurs 20-30 years after exposure
- need significant exposure

25

what is manifestion of asbestosis

lower lobe ILD - other things are cause by asbestos, but not asbestosis

26

Dx and Tx of asbestosis

Dx- Hx and fibers seen on patho
Tx - none

27

what is idiopathic pulm fibrosis

age >50
- seems to be abberant wound healing without significant inflammation
- uncommon
- survivial 2-5 years

28

3 things to make IPF Dx

1. rule out all other caues of ILD
2. CT showing "usual interstitial pneumonia"
3. may need lung biopsy

29

what is Tx for IPF

- NOT steroids - increases mort
- anti-fibrotic agents

30

5 things to include on an ILD Hx

1. resp Sx
2. CT disease Sx
3. toxins
4. exposures
5. risk factors

31

3 parts of PhX for ILD

1. resp exam
2. cardiac exam
3. rheum exam

32

5 tests to order for ILD

1. PFT
2. CXR
3. CT
4. bloods -serology, Ca,
5. path - if haven't figured it out

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