Lung Fibrosis

Question 1

Which drugs increase the risk of fibrosis?

Answer 1

Amiodarone
Nitrofurantoin
Bleomycin
Methotrexate

Question 2

What type of fibrosis is caused by pnemoconiosis?

Answer 2

Fine Inspiratory creptitations

Question 3

What causes basal fibrosis?

Answer 3

LOWER is C-RAID
->Connective tissue disorder
->Rheumatoid arthritis
->Asbestosis
->Idiopathic pulmonary fibrosis
->Drugs

Question 4

What causes apical fibrosis?

Answer 4

UPPER is CHARTHs
Coal worker pneumonicosis
Hypersensitivity pneumonitis
Ankylosing spondylitis
Radiotherapy
Tuberculosis
Histiocytosis
Sarcoidosis

Question 5

What is hypersensitivity pneumonitis?

Answer 5

Inhalation of specific environmental agents can trigger a hypersensitivity reaction in the lungs., from chronicexposure to trigger causing interstitial fibrosis, which includes Farmer;s lung from mould spores on hay or straws

Question 6

Which type of crackles are found in lung fibrosis?

Answer 6

Fine inspiratory creptitations

Question 7

What is Caplan syndrome?

Answer 7

Intrapulmonary nodules in patients with rheumatoid arthritis and pneumonicosis.

Question 8

How long does it take for asbestos to develop?

Answer 8

20-30 years
-> acute onset of shortness of breath, haemoptysis and chest pain

Question 9

How does silicosis present?

Answer 9

Chronic progressive fibrotic lung disease

Question 10

How do coal workers pneumoconiosis present?

Answer 10

Chronic productive sputuma no abnormal appearance of upper lobes on CXR

Question 11

How does beryllium affect the lungs?

Answer 11

Causes granolas and interstitial fibrosis

Question 12

Which autoimmune conditions cause lung fibrosis?

Answer 12

Connective tissue disease like rheumatoid arthritis, systemic lupus, systemic sclerosis and Sjögren’s syndrome

Question 14

What is the criteria for prescribing pirfenidone?

Answer 14

FBC of 50-80%

Question 15

What is the most common cause of cancer associated with assbtos exposure?

Answer 15

Lung cancer

Question 16

What is the most common cause of pneumonicosis?

Answer 16

Simple pneumonicosis

Question 17

When does coal worker pneumonicosis present?1

Answer 17

15-20 years after exposure, and can have black sputum

Question 18

What is Extrinsic allergic alveolitis (EAA) also known as?

Answer 18

Hypersensitivity pneumonitis

EAA is characterized by hypersensitivity-induced lung damage due to inhaled organic particles.

Question 19

What type of hypersensitivity is primarily associated with EAA?

Answer 19

Type III hypersensitivity

Immune-complex mediated tissue damage is the primary cause of EAA.

Question 20

Which type of hypersensitivity is thought to play a role in the chronic phase of EAA?

Answer 20

Type IV hypersensitivity

Delayed hypersensitivity is believed to contribute to the chronic phase of the condition.

Question 21

What is an example of EAA associated with bird droppings?

Answer 21

Bird fanciers’ lung

This condition arises from exposure to avian proteins.

Question 22

What causes farmers lung?

Answer 22

Spores of Saccharopolyspora rectivirgula from wet hay

This was formerly known as Micropolyspora faeni.

Question 23

Which organism is associated with malt workers’ lung?

Answer 23

Aspergillus clavatus

This fungus contributes to hypersensitivity pneumonitis in malt workers.

Question 24

What is a cause of mushroom workers’ lung?

Answer 24

Thermophilic actinomycetes

These microorganisms can lead to hypersensitivity reactions in those who work with mushrooms.

Question 25

What are the acute symptoms of EAA?

Answer 25

Dyspnoea, dry cough, fever ## Footnote Acute symptoms occur 4-8 hours after exposure.

Question 26

What are the chronic symptoms of EAA?

Answer 26

Lethargy, dyspnoea, productive cough, anorexia, weight loss ## Footnote Chronic symptoms develop weeks to months after exposure.

Question 27

What imaging findings are associated with EAA?

Answer 27

Upper/mid-zone fibrosis ## Footnote Imaging studies typically show fibrosis in the upper and mid zones of the lungs.

Question 28

What laboratory finding is indicative of EAA in bronchoalveolar lavage?

Answer 28

Lymphocytosis ## Footnote An increase in lymphocytes is a key indicator in diagnostic evaluations.

Question 29

What serologic assay is used in the investigation of EAA?

Answer 29

Specific IgG antibodies ## Footnote Testing for these antibodies helps confirm the diagnosis of EAA.

Question 30

What blood finding is typically NOT present in EAA?

Answer 30

Eosinophilia ## Footnote A lack of eosinophilia is a distinguishing feature in the blood work of EAA patients.

Question 31

What is the first step in the management of EAA?

Answer 31

Avoid precipitating factors ## Footnote Preventing exposure to the triggering agents is crucial in managing EAA.

Question 32

What medication is commonly used in the management of EAA?

Answer 32

Oral glucocorticoids ## Footnote These are prescribed to reduce inflammation and manage symptoms.

Question 33

Which lung is typically affected in mesothelioma?

Answer 33

Right lung

Question 34

What are the diagnostic investigations for mesothelioma?

Answer 34

CXR Pleural CT Pleural effusion analysed for MC&S

Question 35

What is used to investigate cytology negative exudative effusions?

Answer 35

Thomas cop

Question 36

How should pleural nodulatrity be investigated?

Answer 36

Pleural biospy