Interstitial Lung Disease CIS I Flashcards
(36 cards)
75yo M abnormal CXR, 60py tobacco, myalgias in shoulder and neck, fatigue, sinus infection, hemoptysis, weight loss, T 99F, crackles b/l, b/l lung nodules - cavitated, WBC 10,000
most likely diagnosis
-wegners granulomatosis
wegners granulomatosis
sinusitis
lung
kidney
DDx for cavitary lung lesions
CAVITY
c - carcinoma a - autoimmune - wegners v - vascular i - infection 9 TB, fungal, bacterial t - trauma y - young - congenital lesions
61yo M increasing SOB last year, hacking non-prod cough, a-fib, HTN, rheumatoid arthritis, velcro-like crackles, split S2, pitting lower extremity edema, clubbing
FVC 50%, FEV1 50%, FEV1/FVC 98%
appropriate next step in management
-stop amiodarone and methotrexate
amiodarine and methotrexate
can cause restrictive lung disease
methacholine challenge
for asthma
amiodarone lung
2-4 months at doses greater than 400mg/day
lipid laden foamy alveolar macrophages
organizing pneumonia - 25% of cases - mimics infectious pneumonia
ARDS - post-surgical
diffuse alveolar damage
solitary lung mass
50yo M increasing SOB with exercise, no fever, hemoptysis, weight loss, dry cough, no smoking, lungs crackle, clubbing, diffuse linear opacities, restrictive PFT, decreased diffusion capacity
most likely diagnosis
-idiopathic pulmonary fibrosis
27yo F SOB reently, exercise tolerance dwindled, occasional dry cough, no smoking, O2 90% after exercise, bilateral hilar lymph nodes, restrictive PFT
next appropriate step
-obtain transbronchial lymph node biopsy
diagnostic for sarcoidosis**
61yo F 3 day history of SOB, non-prod cough, fever, hemoptysis 3mL maroon, hx of SLE, cerebritis, lupus nephritis
T 100.4
CXR diffuse b/l infiltrates
PFT increased DLCO - most likely diagnosis
diffuse alveolar hemorrhage
causes of increased DLCO
diffuse alveolar hemorrhage
polycythemia
30yo M syncope, no fever, nonsustained V-tach, positive skin test for anergy, bilateral hilar adenopathy, elevated serum calcium, echo wall abnormality
bx of myocardium
upon receiving biopsy results you will
-begin tx for disorder associated with noncaseating granulomas
noncaseating granulomas
sarcoidosis
22yo F severe dyspnea on exertion, over last 6 months, O2 desat with exercise, enlarge pulmonary vasculature, V/Q normal, right heart strain, DLCO and PFT normal
next test to order for Dx?
right heart cath
-assess cause of pulmonary HTN
30yo M 15py tobacco, URI tx with azithromycin 3 weeks ago, 3 days ago SOB, cough hemoptysis, lips cyanotic, 2 + edema, BUN 60, Cr 4, microscopic hematuria
most help confirm dx
C-ANCA
wegners
C-ANCA
wegners
anti-GM BM antibodies
goodpastures
kveim test
sarcoidosis
alpha1 antitrypsin
early emphysema
goodpastures vs. wegners
history of URI - possible sinus involvement
37yo AA M raised red lesions on anterior both legs, SOB, dry cough, no fever, never smoked, dry rales b/l, irregular heart rhythm, AV block, hilar adenopathy, noncaseating granulomas, PFT restrictive, elevated Ca and ACE
erythema nodosum
-sarcoidosis
Tx plan - high dose systemic corticosteroids
treat a patient that is symptomatic**
hilar adenopathy without symptoms
sarcoidosis
-tx watchful waiting
75yo M severe dyspnea 1 year, 100py tobacco, stone engraver, expiratory crackles b/l, clubbing, eggshell calcifications of hilar lymph nodes
most likely dx
-silicosis
eggshell calcifications
silicosis
