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Year 2 Respiratory > Interstitial lung disease > Flashcards

Interstitial lung disease Flashcards

1
Q

characterization of ILD

A

cellular infiltration
scarring
architectural disruption of parenchyma

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2
Q

ILD can compromise what locations of the lung?

A

alveolar wall
septum interstitium
lumina and walls of small airways

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3
Q

clinical presentation of ILD

A 
acute, subacute or chronic 
progressive dyspnea on exertion 
dry cough 
restrictive PFTs 
CXR / CT - interstitial infiltrates with ground glass opacities
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4
Q

physical exam for ILD

A 
clubbing 
erythema / nodosum / arthritis / rash 
tachypnea 
dry crackles / squeaks 
increased right heart pressures
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5
Q

what may be the earliest change in PFTs in the context of ILD?

A

decreased DLCO

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6
Q

what is the radiographic distribution of ILD?

A

upper / lower

central / peripheral

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7
Q

what is the granulomatous ILD?

A

sarcoidosis

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8
Q

which idiopathic interstitial pneumonitis (IIP) has the worst prognosis?

A

idiopathic pulmonary fibrosis (IPF)

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9
Q

what are the radiographic characteristics of IPF?

A
  1. lower lobes and peripheral distribution of reticular infiltrates
  2. fibrotic changes
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10
Q

what is the clinical use for nintedanib?

A

IPF

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11
Q

what are two medications for IPF?

A

nintedanib

pirfenidone

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12
Q

what is the clinical use for pirfenidone?

A

IPF

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13
Q

what is the radiographic presentation of nonspecific interstitial pneumonitis (NSIP)?

A

ground glass opacity symmetrically in the lower lung zones, with or without reticular infiltrates

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14
Q

DIP

A

desquamative interstitial pneumonitis

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15
Q

RB-ILD

A

respiratory bronchiolitis associated ILD

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16
Q

DIP and RB-ILD are associated with what activity?

A

smoking

17
Q

AIP

A

acute interstitial pneumonitis

18
Q

DAD

A

diffuse alveolar damage

19
Q

what is the radiographic presentation of AIP / DAD?

A

diffuse, bilateral air space and reticular infiltrates

20
Q

what is the problem associated with AIP / DAD? what is the treatment?

A

oygenation

supportive

21
Q

COP

A

cryptogenic organizing pneumonia

22
Q

patients with COP present with what type of symptoms?

A

pneumonia

23
Q

what is the treatment for COP? what is the prognosis?

A

corticosteroids

good

24
Q

what is the radiographic presentation for COP?

A

patchy infiltrates, unilateral or bilateral
50% small nodular opacities
consolidation and air bronchogram seen on HRCT
subpleural and peribronchiolar distribution

25
Q

what is the mechanism for hypersensitivity pneumonitis?

A

cell mediated immunity - activation of alveolar macrophages and CD8 influx with ill defined granuloma formation

26
Q

what is the acute presentation of hypersensitivity pneumonitis? (onset, PE, imaging)

A

abrupt onset of flu like symptoms
tachypnea and diffuse fine crackles
radiograph - normal or patchy, micronodular opacities

27
Q

how does chronic presentation of hypersensitivity pneumonitis differ from acute?

A

digital clubbing

irreversible respiratory findings - FIBROSIS

28
Q

what drug can cause commonly cause drug induced ILD?

A

amiodarone

29
Q

what are highly suggestive radiographic findings for HP (hypersensitivity pneumonitis)?

A

ground glass opacification and centrilobular nodules

30
Q

what are the radiographic findings of amiodarone toxicity?

A

ground glass and reticular opacities

increased attenuation liver and spleen seen on abdominal cuts

31
Q

what are the two presentations for nitrofurantoin toxicity? what are the symptoms?

A

acute and chronic onset

acute - peripheral blood eosinophilia
chronic - increased serum Ig, serum transaminases, ESR, ANA+

32
Q

what is the radiographic presentation of acute eosinophilic pnuemonia?

A

bilateral patchy ground glass and/or reticular opacities

increased eosinophilic count (over 25%) - key

33
Q

what is the radiographic presentation of chronic eosinophilic pnuemonia?

A

bilateral peripheral or pleural based opacities described as “photographic negative” of pulmonary edema

subpleural consolidations, predominantly upper lobes

34
Q

what are the features of lymphangioleiomyomatosis?

A 
progressive cystic lung disease 
women of childbearing age 
associated with tuberous sclerosis 
proliferation of SMCs 
dyspnea on exertion, cough, hemoptysis
35
Q

what is the radiographic presentation of lymphangioleiomyomatosis?

A

diffusely distributed thin walled cysts

36
Q

what is the evaluation of ILD following history and PE?

A

chest radiography
blood tests
PFTs

Year 2 Respiratory (34 decks)

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