January 26, 2016 - Diagnosis and Management of ILD Flashcards Preview

COURSE 3 > January 26, 2016 - Diagnosis and Management of ILD > Flashcards

Flashcards in January 26, 2016 - Diagnosis and Management of ILD Deck (11):
1

Type I Pneumocyte

Flattened region of gaseos transport/diffusion, which is vulnerable to injury.

2

Type II Pneumocyte

Site of surfactant synthesis.

Can proliferate and re-form alveolar epithelial surface.

3

Non-Pharmacologic Management of ILD

Smoking cessation

Infection prevention

Pulmonary rehabilitation

Oxygen supplementation 

Manage co-morbidities (GERD, OSA (obstructive sleep apnea), CHF)

4

Pharmacologic Management

1. Immuno-modulatory therapies

2. Anti-fibrotic therapies (IPF only)

5

Sarcoidosis

A multisystem granulomatous disorder of unknown etiology.

Affects individuals worldwide.

Characterized histologically by the presence of non-caseating granulomas in the affected organs.

~50% is detected incidentally on CXR.

A image thumb
6

Organ Involvement of Sarcoidosis

Lungs - 95%

Skin - 16%

Lymph nodes - 15%

Eye - 12%

Liver - 12%

Erythema Nodosum - 8%

Spleen - 7%

7

Sarcoidosis - Histology

Granulomatous (non-caseating) inflammation.

A image thumb
8

Indications for Treatment - Sarcoidosis

60-80% of asymptomatic patients have spontaneous remission.

Consider treatment if it is progressive symptomatic pulmonary, neurologic, ocular, hypercalcemia/renal, or cardiac

9

Treatment - Pulmonary Sarcoidosis

Glucocorticoids (First line) - prednisone

Methotrexate

Azathioprine

Combination therapy

Lung transplantation

10

Signs of Restrictive Spirometry

FEV1/FVC > 70%

Low FVC (<80%)

Low FEV1 (<80%)

Low DLCO

11

Idiopathic Pulmonary Fibrosis (IPF)

The most common of the idiopathic ILD's.

Chronic progressive parenchymal lung disease of unclear origin.

Median survival is 3-5 years from diagnosis.

Usually affects those aged >50

2 therapies now available; pirfenidone and nintedanib

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