Flashcards in Interstitial Lung Disease Deck (63)
What medication is most commonly used to try to prevent progression of pulmonary fibrosis?
High dose corticosteroids
What is the only definitive treatment option for pulmonary fibrosis, and who could receive it?
Lung transplant- given to patients aged < 65 with severe, progressive disease
What are some interventions that may help to relieve symptoms of pulmonary fibrosis?
Pulmonary rehabilitation and oxygen therapy
What is the most common type of hypersensitivity pneumonitis in the UK?
Bird fancier's lung
What is the relationship between smoking and hypersensitivity pneumonitis?
Smoking reduces the risk of developing hypersensitivity pneumonitis
Where in the lungs is pulmonary fibrosis caused by hypersensitivity pneumonitis most commonly found?
The upper lobes
What are the three main features of interstitial lung disease?
Progressive breathlessness, restrictive lung function pattern, reduced transfer factor
The diagnosis of ILD mainly depends on the use of what investigation?
High resolution CT
What are the two most common interstitial lung diseases?
Idiopathic pulmonary fibrosis and sarcoidosis
Name some potential causes of pulmonary fibrosis?
Idiopathic, connective tissue disease, drugs, radiotherapy, ARDS
What blood test should be done to rule out connective tissue disease as a cause of pulmonary fibrosis?
What blood test should be done to rule out hypersensitivity pneumonitis as a cause of pulmonary fibrosis?
What blood test should be done to rule out sarcoidosis as a cause of pulmonary fibrosis?
What will a high resolution CT of pulmonary fibrosis show?
A ground-glass appearance and honeycombing
What further investigation can be used in those with suspected pulmonary fibrosis to exclude other diagnoses?
Bronchoscopy and bronchoalveolar lavage
What are the three main areas of management for pulmonary fibrosis?
Treat any underlying cause, advise smoking cessation, prevent progression with medical treatment
Give some examples of drugs which can potentially cause pulmonary fibrosis?
Chemotherapy agents, DMARDs and amiodarone
Name some risk factors for the development of pulmonary fibrosis?
Male, increased age, smoking, occupational exposure to fumes and dusts
What is the median age for presentation with idiopathic pulmonary fibrosis vs. pulmonary fibrosis associated with connective tissue disease?
70 years for idiopathic, 50-60 years for CTD
What happens to the total lung volume in pulmonary fibrosis?
What happens to the FVC in pulmonary fibrosis?
What happens to FEV1 in pulmonary fibrosis?
What happens to the FEV1: FVC ratio in pulmonary fibrosis?
Normal (> 75%)
In sarcoidosis, affected tissues are infiltrated with what?
Describe the typical demographic of an individual affected by sarcoidosis?
Female, 20-40 years, Afro-Caribbean ethnicity
What type of hypersensitivity reaction is sarcoidosis?
Describe the four main features of acute sarcoidosis?
Bilateral hilar lymphadenopathy, fever, arthralgia, erythema nodosum
What respiratory symptoms can be seen in sarcoidosis?
Dry cough and dyspnoea
Eventually, progressive sarcoidosis leads to what respiratory change?