Interstitial Lung Disease Flashcards Preview

Clinical Medicine- Pulmonary > Interstitial Lung Disease > Flashcards

Flashcards in Interstitial Lung Disease Deck (27):
1

This is the most common cause of interstitial lung disease?

Idiopathetic pulmonary fibrosis

2

Pathophysiology of ILD?

Lung sustains an injury. Due to exhausted resources or imperfect repair system, the injury is retained. ILDs can involve excess collagen deposition into the interstitium and surrounding tissues. This leads to fibrotic tissue deposition in the lung and impaired capillary gas exchange.

3

Clinical presentation of ILD?

Dyspnea on exertion that is progressive, non productive dry cough, pleuritic chest pain

4

Physical exam findings of ILD?

Coarse crackles, wheezing IS NOT common, clubbing of finger nails if in severe stage, cyanosis

5

Diagnostic testing for ILD?

CXR, high resolution CT scan (HRCT), pulmonary function testing (PFT)

6

This will be present on PFT of ILD?

Restrictive patterns, decrease in TLC.

7

Pathogensis of idiopathic pulmonary fibrosis?

Fibrosis of parenchyma of lungs. Thought to be a result of aberrant promotion of fibroblast and subsequent collagen deposition of epithelial surfaces. Fibrosis spreads from alveoli to alveolar lumen and adjacent lung parenchyma

8

Physical exam findings for IPF?

MAY reveal crackles, clubbing, cyanosis, pulm HTN, pedal edema, holosystolic tricuspid regurg murmur

9

Findings on CXR? Finding on CT

CXR: opacities and densities, especially lower lobs with loss of volume. CT: Honeycombing

10

These values would indicate oxygen therapy?

SpO2

11

Sarcoidosis is a systemic disease that involves?

formation of granulomas, found commonly in the tissues of lungs and lymph nodes of throacic region

12

Having a first degree relative with sarcoidosis increases your risk this much?

5 fold. Genetics likely play a role

13

Clinical manifestation of sarcoidosis?

Dyspnea, cough, chest pain. Fatigue, night sweats, weigh loss can occur

14

Sarcoidosis can eventually progress to?

Pulmonary fibrosis

15

ENT presentation of sarcoidosis

anosmia, erosion of cartilage nasal septum, deformity, stridor, dysphonia, dysphagia and cough

16

Dermatologic presentation of sarcoidosis?

Maculopapular lesions w/ red/violaceous appearance

17

Why would you test serum ACE levels?

sarcoid granulomas produce angiotensin converting enzyme but only elevated in 60% of sarcoid patients.

18

Most conditions of sarcoidosis are treated with?

oral prednisone

19

Unlike other ILD, fibrotic lesions are reversible in this disease?

Cryptogenic organizing pneumonia (COP)

20

Clinical presentation of crypgenic organizing pneumonia

cough, dyspnea, malaise, fever. onset is typically weeks to months, weight loss of greater than 10lbs in over 50%

21

CXR findings

bilateral consolidation that can be patchy or diffuse

22

CT scan on COP

Patchy opacities are more frequently found in periphery of lung fields in lower portions of lungs

23

These are higher in COP than IPF?

Lymphocytes, neutrophils, eosinophiles

24

Treatment of COP depends on?

Severity

25

Sever or progressing COP treatment?

If patient failed steroids, cyclophosphamide. May also need macrolide antibiotic

26

Mild to moderate COP treatment?

Macrolide therapy: Clarithromycin 250-500mg BID 3-6 months

27

Sever COP treatment?

4-8 wks PO steroids (0.75-1mg/kg/day). taper over 4-6 weeks.