Lung 4

Question 1

sarcoidosis

Answer 1

noncaseating granulomas involving multiple organ systems

Question 2

diagnosis of exclusion

Answer 2

sarcoidosis (2 others)

Question 3

difference between TB and sarcoidosis

Answer 3

sarcoidosis has no infection and rarely necrosis

TB is an infection and has necrosis

Question 4

respiratory symptoms of TB

Answer 4

cough
dyspnea
pain

Question 5

constitutional symptoms with TB

Answer 5

fever
weight loss
fatigue
anorexia
night sweats

Question 6

lymphocyte associated

Answer 6

CD4/Th1

Question 7

cytokines associated

Answer 7

IL2

INFgamma

Question 8

antibody associated

Answer 8

IgG (elevated)

Question 9

genetic risk factors

Answer 9

familial

HLA associations

Question 10

3 main factors for etiology of sarcoidosis

Answer 10

immunologic factors
genetic factors
environmental factors

Question 11

organs involved in sarcoidosis

Answer 11

spleen
BM
skin
eye
salivary glands
muscle
lungs

Question 12

Lofgren syndrome

Answer 12

associated with sarcoidosis
fever
bilateral hylar lymphandenopathy, polyarthralgias
common in Scandanavians

Question 13

Skin symptoms of sarcoidosis

Answer 13

erythema nudism
panniculitis
lupus pernio (most common)
rash of cheeks and nose

Question 14

eye issues with sarcoidsosis

Answer 14

granulomatous uveitis or conjunctival lesions/scleral plaques

Question 15

how are granulomas found in sarcoidosis

Answer 15

PET scans- take up more glucose

Question 16

abnormal lab values associated with sarcoidosis

Answer 16

hypercalcemia
hypercalcinuria
high ACE
high alkaline phosphatase

Question 17

CO diffusion test

Answer 17

decreased in sarcoidosis

Question 18

restrictive or obstructive for sarcoidosis

Answer 18

restrictive

Question 19

sarcoidosis treatmetn

Answer 19

NSAIDs

possible corticosteroids for extra pulmonary disease or persistent pulmonary disease

Question 20

hypersensitivity pneumonitis

Answer 20

immune mediated interstitial lung disorder caused by exposure to inhaled organic dusts

Question 21

hot tub lung

Answer 21

HP caused by mycobacterium avid complex from poorly maintained indoor hot tubs

Question 22

HP restrictive or obstructive?

Answer 22

restrictive- reduced FVC

Question 23

causative agent for hot tub lung

Answer 23

MAC

Question 24

immunology of hypersensitivity pneumonitis

Answer 24

increase pro inflammatory cytokines
increased T lymphocytes
immune complexes
non caveating granulomas

Question 25

pulmonary eosinophilia

Answer 25

lots of eosinophils in airways from unknown cause

Question 26

types of pulmonary eosinophilia

Answer 26

``` acute eosinophilic pneumonia with respiratory failure simple pulmonary eosinophilia tropical secondary idiopathic chronic ```

Question 27

smoking associated diffuse interstitial lung diseases

Answer 27

desquamative interstitial pneumonia (DIP) | respiratory bronchiolitis associated interstitial disease (RBILD)

Question 28

DIP and RBILD characteristics

Answer 28

pigmented macrophages in air space lack of fibrosis 40-50y M>>F

Question 29

DIP RBILD CXR

Answer 29

nodular with some interstitial infiltrate in lower lobes

Question 30

drug induced lung disease

Answer 30

interstitial fibrosis bronchiolitis obliterans eosinophilic pneumonia

Question 31

pulmonary alveolar proteinosis

Answer 31

filling of airspaces with gelatinous sputum

Question 32

CXR PAP

Answer 32

bilateral, patchy asymmetric infiltrate

Question 33

cause of PAP

Answer 33

hereditary- mutations in GM-CSF and/or GM-CSF receptors | secondary

Question 34

diagnosis

Answer 34

pink proteinaceous fluid no inflamamtion PAS positive with cholesterol clefts

Question 35

treatment for PAP

Answer 35

BAL | lung transplant in children

Question 36

major cause of pulmonary embolism

Answer 36

DVT in leg

Question 37

gene involved with primary hypertension

Answer 37

BMPR2

Question 38

plexogenic pulmonary arteriopathy

Answer 38

smooth muscle hyperplasia

Question 39

presentation of primary HTN

Answer 39

women 20-40 | dyspnea, fagitue --> can progress to respiratory distress, cyanosis, RVH

Question 40

goodpasture syndrome

Answer 40

auto antibodies against collage 4 | leads to glomerulonephritis and kidney failure

Question 41

idiopathic pulmonary hemosiderosis

Answer 41

too much iron in lung, rare, seen in kids