Notes in Interstitial Lung Disease

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Published	11/02/2023	Interstitial Lung Diseases• also called {{c1::diffuse parenchymal}} lung disorders• heterogenous group of disorders grouped together due to similar cl…
Published	11/02/2023	pulmonary {{c1::interstitium}} consists of alveolar {{c2::epithelial}} cells, pulmonary capillary {{c2::endothelium}}, peri{{c3::vascular}} and peri{{…
Published	11/02/2023	Gas exchange via diffusion- {{c1::directly}} proportional to {{c3::partial pressure}} (concentration gradient)- {{c1::directly}} proportional to …
Published	11/02/2023	Pulmonary {{c1::Fibrosis}} present with interstitial thickening → increases diffusion distance → decreases efficiency of gas exchange
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Published	11/02/2023	Clinical Approach to ILDs- age: >50 is more typical of {{c1::IPF}}- gender: {{c3::women > men}}*except in {{c2::RA}} and {{c2::IPF}} - symp…
Published	11/02/2023	Medication history of {{c1::methotrexate}}, {{c1::amiodarone}}, {{c1::nitrofurantoin}} → high risk for ILDsSocial history of {{c2::smoking}} → IPF, RB…
Published	11/02/2023	Physical exam findings in ILDs- {{c4::tachypnea}}- {{c4::clubbing}}: rounding of ringer nail buds - exercise {{c2::desaturation}}: rapid drop in …
Published	11/02/2023	REVIEW: end-expiratory wheezing found in {{c2::COPD}} and {{c2::asthma}}{{c3::rhonchi}} found in larger airway obstructions in …
Published	11/02/2023	Diagnostic tests for ILD- {{c2::blood}} testing: for potential autoimmune causes of ILD - {{c1::PFTs}} such as spirometry- high-resolution CT ima…
Published	11/02/2023	In ILD, lung function tests shows the following:lung has more collapsing recoil force→ {{c1::FEV1/FVC}} ratio is within normal range FEV1 and FVC a…
Published	11/02/2023	in ILD, maximal expiratory flow rate at a given lung volume is higher than normal due to increased {{c1::radial traction}} on airway → higher airway d…
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Published	11/02/2023	Idiopathic Pulmonary Fibrosis (IPF)• Age of onset: {{c1::6th}} and {{c1::7th}} decade; rare < 50 years unless associated with genetic pre…
Published	11/02/2023	IPF pathology: usual interstitial pneumonia with {{c1::fibrosis}} and architectural distortion*temporal and spatial heterogeneity
Published	11/02/2023	IPF Treatment• O2 therapy• Pulmonary {{c1::rehabilitation}} with upper extremity exercises • Anti{{c2::fibrotics}}: → {{c3::Nintedanib}}: tyrosine ki…
Published	11/02/2023	Hypoxemia in ILD is primarily caused by {{c1::diffusion impairment}}
Published	11/02/2023	Non-Specific Interstitial Pneumonia (NSIP)• Second most common diagnosis (right after {{c3::IPF}})• Middle-aged, more common in females • Clubbing is…
Published	11/02/2023	{{c1::Connective}} Tissue-Related ILD • seen in patients with {{c2::Systemic Lupus Erythematosus (SLE)}}, {{c3::Rheumatoid Arthritis}}, and …
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Published	11/02/2023	Sarcoidosis• multi{{c1::system}} (CNS, Eye, Skin, Bone, Cardiac, Endocrine) disease of unknown etiology*may present acutely, subacutely, or chronicall…
Published	11/02/2023	Hypersensitivity {{c3::Pneumonitis}} (HP)• From inhalation of and sensitivity to {{c1::organic dusts}}*antigens are quite varied but clinical res…
Published	11/02/2023	{{c1::Cryptogenic Organizing Pneumonia}} (COP)• unknown etiology but can be associated with viral and bacterial pneumonias, inhaled toxins, drugs…
Published	11/02/2023	{{c2::Respiratory Bronchilotis}}-ILD (RB-ILD)• Radiology abnormal in 80% - fine reticular or reticulonodular infiltrates• Path: pigmented macroph…
Published	11/02/2023	Acute Interstitial Pneumonia (Hamman-Rich Syndrome)• Rapid onset of symptoms and rapid progression to {{c1::respiratory failure}} • Diffuse opacities …
Published	11/02/2023	{{c1::IPF}} is the ILD that has the worst prognosis
Published	11/02/2023	Steroids are NOT helpful in treating {{c1::IPF}}
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