Interstitial Lung Disease II Flashcards Preview

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Flashcards in Interstitial Lung Disease II Deck (41)
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1
Q

50yo F, dyspnea, cough, bibasilar fine crackles, clubbing, CXR basilar opacities, calcified pleural plaques

A

asbestosis

2
Q

calcified pleural plaques

A

asbestosis

3
Q

BOOP

A

on CXR - looks like pneumonia

won’t get better with antibiotic

4
Q

kaplans syndrome

A

rheumatoid arthritis and pneumoconiosis

5
Q

22yo M Hx asthma, mild intermittent, albuterol 1x/week, runs 2 miles/day

PFT reveal?

A

greater than 20% decline in FEV1 on methacholine challenge test

6
Q

restrictive lung disease

A

reduced FEV1 and FVC

with elevated FEV1/FVC ration

7
Q

25yo severe asthma, cold on day of exacerbation, chemical fume inhalation, unable to breathe

RR 44
diaphoretic, suprasternal retractions, bialteral wheezes, , given albuterol and IV corticosteroids

A

next step - inhaled corticosteroids

8
Q

65yo M, CXR rounded opacities upper lung zones, egg shell calcifications, increasing SOB last 2 years, accesory mm respiration, fine crackles end expiration

A

silicosis

  • risk fx for TB
  • so do a PPD skin test
9
Q

65yo M, mine worker, increasing SOB, sleeps on sofa, right side HF, 2+ pretibial edema, diffuse qheezing

A

coal workers pneumoconiosis

pulmonary HTN > cor pulmonale

10
Q

anti-GBM

A

goodpastures

11
Q

non-caseating granulomas

A

sarcoidosis

12
Q

fibrous plaques, pleural fibrosis

A

asbestosis

13
Q

chronic mucopurulent infections causing dilation of resp bronchioles

A

bronchiectasis

14
Q

coalescence of particle containing macules that form discrete areas of interstitial fibrosis causing distention of resp bronchioles, forming focal areas of emphysema

A

coal workers pneumoconiosis

15
Q

35yo coal miner rheumatoid arthritis

-calcified pulmonary nodules on CXR

A

dx - kaplans syndrome

16
Q

silicosis

A

egg shell calcifications

17
Q

miliary TB

A

spots all over CXR

18
Q

47yo roofer, increased SOB, 30py tobacco, roofing industry worker, CXR irregular shadows lower lung zones, thickened pleural plaques under diaphragms

A

asbestosis

decreased DLCO
decreased total lung capacity

19
Q

asbestosis

A

golden brown, fisuform rods with translucent center consisting of particulat fibers coated with iron containing proteinaceous material

ferruginous bodies**

20
Q

ferruginous bodies

A

asbestosis

21
Q

65yo M increasing SOB, weight loss last 3 months, positive JVD, distant heart sounds, pulsus paradoxus, diminshed breath sounds base of lung on left

right side pleural effusion and pericardial effusion

works on shipyard

thoracentesis reveals?

A

pleural fluid analysis with malignant mesothelioma

asbestosis

22
Q

berrylium

A

nuclear exposure

like sarcoidosis

23
Q

transudate vs. exudate

A

exudate if:
-pleural protein/serum protein > 0.5

  • pleural fluid LDH/serum LDH > 0.6
  • pleural fluid LDH more than 2/3 normal upper limit for serum
24
Q

35yo M, dyspnea, anorexia, night sweat, weight loss, nuclear technician, decreased breath sounds b/l, CXR bilateral fibrosis with hilar adenopathy, normal ACE and Ca levels, positive for mumps and trichophyton

A

beryllium exposure

BAL for beryllium lymphocyte proliferation test

25
Q

heerfordts syndrome

A

variant of sarcoidosis

parotitis, uveitis, mild fever, facial nerve paralysis

26
Q

25yo M, upholstery industry, polyurethane exposure, wheezing episodes at work

spirometry shows?

A

wheezing - FEF25-75 decreased- obstructive pattern

dx - TDI lung disease - polyurethane business

27
Q

CXR with dextrocardia

not surprised to find?

A

no children

  • kartagener syndrome
  • primary ciliary dyskinesia
28
Q

25yo male, dry cough, malaise, fevers, wheezing, weight loss, eosinophilia, LgE elevations, charcot leyden drystals, multiple nodules on CXR

treat with?

A

eosinophilia pneumonia?

  • parasite
  • tx diethylcarbamazine

wuchereria bancrofti

29
Q

wuchereria bancrofti

A

elephantitis

-parasitic infection

30
Q

14yo F, blood eosinophilia, fever, pulmonary infiltrates, episodic, abdomen pain, N/V, X-ray acute GI obstruction

diagnosis?

A

loefflers syndrome

parasite life cycle

  • strongyloides
  • lung phase an GI phase of life cycle
31
Q

churg strauss

A

asthma like sx
progressive dx
diarrhea, abdominal pain

32
Q

loefflers syndrome

A

intermittent disease

  • parasites in GI and lungs
  • strongyloides
33
Q

38yo F, tx for breast ca mastectomy, low grade fever, night sweats, dyspnea, increased sputum, occasional cough

suspect?

A

chronic remodeling of lung tissue resulting in pulmonary fibrosis

radiation treatment effect on lungs

34
Q

30yo rancher, fever, chills, cough, progressive SOB, wheezing increased over past 4 hours, diffuse infiltrates on CXR

A

learn more about ranch duties, surmise his problem is result of?

allergy to thermophylic actinomycetes

farmers lung

35
Q

farmers lung

A

thermophylic actinomycetes

36
Q

50yo M, sinusitis, allergies, persistent asthma, beta agonists, steroids, cromolyin, resp difficulty, pain legs, arms, hands, erythematous maculopapules, abdominal pain with rebound, decreased urination

right side infiltrates, elevated eosinos, p-ANCA elevated, IgE elevated, BUN/Cr elevated

A

diagnosis
-churg strauss syndrome

looked like wegeners - but no hematuria

37
Q

pANCA

A

churg strauss

38
Q

25yo hodgkins, chemotherapy, fever 3 days, dry cough and hemoptysis with pleuritic chest pain

BAL - suggest aspergillosis

A

most appropriate therapy - amphotericin B

-antifungal

39
Q

amphotericin B

A

antifungal

40
Q

27yo ranchhand, resp distress, cleaning at farm, CXR all white, see air bronchograms

A

diagnosis

-silo fillers disease

41
Q

nitrogen dioxide

A

silo-fillers disease

can be fatal