Interstitial and Infilt ti ra ve Lung Diseases

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Interstitial and Infilt ti ra ve Lung Diseases"

Transcription

1 Interstitial and Infiltrative ti Lung Diseases

2 Case 0 65 year male with chronic dyspnea. A was veteran with multiple occupations including construction and shipyard work. Physical exam shows clubbing and bibasal crepitations. CXR shows small lungs and bilateral interstitial opacities. PFTs show FEV1 60%, FVC 60%, FEV1/FVC 90%, TLC 58%, DLCO 56%. All other history, physical examination and lab work is negative.

3 Case 0 What is your diagnosis? How do you manage this patient?

4 Case 1 A35 year old ldafi African American female presents to the pulmonary clinic for cough and dyspnea for six weeks. She was seen by her primary care physician on multiple occasions, and was prescribed trimethoprim/sulfamethoxazole, azithromycin and levofloxacin on multiple occasions after she was found to have bilateral infiltrates on her chest X ray

5 Case 1 List the main differential diagnoses based on the information so far.

6 Case 1 Further questioning reveals that she has also noted raised red lesions on her skin, a red eye for the last two weeks and has noted multiple painless nodules in her neck and groin region She was recently incarcarated (one month before the onset of these symptoms), but is not sure if anyone she came in contact with had tuberculosis Physical examination confirms posterior uveitis and cervical, axillary and inguinal lymphadenopathy. Pulmonary examination is remarkable for dyspnea and bibasal crepitations

7 Case 1 List your main differential diagnoses at this point

8 Case 1 At tuberculin purified protein derivative test t (ppd) is placed and is negative Laboratory examination is remarkable for hypercalcemia and elevated serum ACE levels Chest X ray and CT examination of chest show diffuse interstitial opacities and extensive mediastinal lymphadenopathy

9 Case 1 What is the next step in evaluating/treating this patient

10 Case 1 A bronchoscopy and transbronchial biopsy is performed Biopsy shows noncaseating granulomatous lesions Mycobacterial and fungal cultures are all negative

11 Case 1 What is your final diagnosis? What stage of disease does this patient have? Would you treat this patient? What options do you have with regards to treatment?

12 Case 2 A45 year female with chronic recurrent urinary tract t infections presents with progressive dyspnea and cough. She is on nitrofurantoin, vitamins and calcium supplements, all of which h she has been taking for years. Physical examination shows bibasal crepitations. CXR and CT shows bilateral interstitial infiltrates. PFTs show a FEV1/FVC of 85%, FVC of 65%, TLC of 65% and DLCO of 45% All other laboratory evaluation is negative.

13 Case 2 What is your differential diagnosis at this point? How would you treat this patient?

14 Case 3 A 36 year old female with long standing rheumatoid arthritis which is poorly controlled, presents to the pulmonary clinic i with progressive dyspnea and cough for the past ttwo months. Her medications include prednisone, methotrexate, hydroxychloroquine and ibuprofen.

15 Case 3 Physical examination shows joint changes consistent with advanced rheumatoid arthritis and bibasal crepitations Chest X ray and CT shows bilateral diffuse interstitial opacities PFTs show FEV1/FVC of 85%, FEV1 of 60%, FVC of 60%, TLC of 60% and DLCO of 40%

16 Case 3 List your differential diagnoses at this point How would you proceed to diagnose and treat this patient

17 Case 4 A42 year male with ithhistory of nonresolving sinusitis and nasal septal perforation presents with a cough, constitutional symptoms and hemoptysis for two weeks. He also complains of cloudy urine and swelling of ankles and face. Physical examination shows the nasal septal perforation, right lower lobe crepitations and pedal edema

18 Case 4 CXR shows a right lower lobe infiltrate with a thick walled cavity His creatinine is elevated, and urinalysis shows hematuria and RBC casts Sputum cultures are all negative for bacterial, mycobacterial and fungal organisms Blood tests are positive for c-anca and p- ANCA (Anti Neurtophilic Cytoplasmic Antibody) Transbronchial biopsy shows granulomatous vasculitis

19 Case 4 What is your diagnosis? How would you treat this patient?

20 Case 5 A42 year old nonsmoking female presents with cough and dyspnea for the last four months. She admits to couging small quantities of blood intermittently. Physical examination shows bilateral wheezing, and a scar on the side of his chest, which according to her was for a tube that was placed for a collapsed lung three month ago. CBC is unremarkable. FEV1/FVC is 60%, FEV1 is 55%, FVC is 80%, TLC is 140%, DLCO is 55%. CXR shows hyperinflation and some reticular prominence, and a right sided small pleural effusion. HRCT chest shows diffuse thin walled round cysts without any ground glass opacities, airspace consolidation or honeycombing.

21 Case 5 This presentation ti is consistent t with: (More than one may be correct) Bronchial asthma COPD Chronic eosinophilic pneumonia Idiopathic pulmonary fibrosis (Usual interstitial pneumonitis) Acute interstitial pneumonitis Acute eosinophilic pneumonia Cryptogenic organizing pneumonia Lymphangioleiomyomatosis Pulmonary langerhans cell histiocytosis

22 Case 6 A35 year old male smoker presents with cough and dyspnea for the last two months. Physical examination shows bilateral wheezing, and a scar on the side of his chest, which according to him was for a tube that was placed for a collapsed lung one month ago. CBC is unremarkable. FEV1/FVC is 60%, FEV1 is 55%, FVC is 70%, TLC is 70%, DLCO is 55%. CXR and CT show bilateral cysts and nodules more prominent in the upper zones, without t any volume loss, and clear costophrenic sulci.

23 Case 6 This presentation is consistent with: (More than one may be correct) Bronchial asthma COPD Chronic eosinophilic pneumonia Idiopathic pulmonary fibrosis (Usual interstitial pneumonitis) Acute interstitial pneumonitis Acute eosinophilic pneumonia Cryptogenic organizing pneumonia Lymphangioleiomyomatosis Pulmonary langerhans cell histiocytosis

24 Case 7 A 75 year old male with no significant ifi history presents to his PCP for evaluation of progressive dyspnea for the past 4 months. No significant drug or exposure history is present. Physical examination shows a comfortable patient with bibasal coarse velcro crepitations and clubbing. Remaining history and physical is negative. CXR shows bilateral interstitial markings in the bases. HRCT shows bilateral subpleural reticular abnormalities with honeycombing and without any ground glass abnormalities. PFTs show a FEV1/FVC of 85%, FEV1 of 65%, FVC of 65%, TLC of 65% and DLCO of 45%. BAL shows neutrophilia but is negative otherwise.

25 Case 7 This presentation is consistent with: (More than one may be correct) Acute eosinophilic pneumonia Pulmonary langerhans cell histiocytosis Chronic eosinophilic pneumonia Idiopathic pulmonary fibrosis i (Usual interstitial titi pneumonitis) Acute interstitial pneumonitis Cryptogenic organizing pneumonia Lymphangioleiomyomatosis

26 Case 7 What are the treatment options for this patient?

27 Case 8 A45 year male with ithaids presents to the pulmonary clinic for five weeks of dry cough and constitutional symptoms. Physical exam shows occational basal crepitations. CXR shows bilateral diffuse interstitial opacities. Differential diagnoses? Diagnostic/therapeutic plan?

28 ILDs: History Acute/Subacute/Chronic Dyspnea Cough Other symptoms, depending on associated conditions Exposure, drugs, connective tissue disorders, Exposure, drugs, connective tissue disorders, other system involvement etc.

29 ILDs: Physical Examination Dyspnea/tachypnea Crackles Clubbing Hypoxemia Other findings depending on the cause Eye, joint, skin findings etc.

30 ILDs: Diagnostic tests Cell counts Eosiniphilia etc. Chemistry Renal function, calcium etc. Specific tests Serum precipitins, connective tissue serology, ACE levels etc. PFTs Restrictive Lung biopsy

31 ILDs: Treatment Removing offending agent Immunosppressants Prednisone Others Oxygen Lung transplantation

Pulmonary interstitium. Interstitial Lung Disease. Interstitial lung disease. Interstitial lung disease. Causes.

Pulmonary interstitium. Interstitial Lung Disease. Interstitial lung disease. Interstitial lung disease. Causes. Pulmonary interstitium Interstitial Lung Disease Alveolar lining cells (types 1 and 2) Thin elastin-rich connective component containing capillary blood vessels Interstitial lung disease Increase in interstitial

More information

April 2015 CALGARY ZONE CLINICAL REFERENCE PULMONARY CENTRAL ACCESS & TRIAGE

April 2015 CALGARY ZONE CLINICAL REFERENCE PULMONARY CENTRAL ACCESS & TRIAGE April 2015 CALGARY ZONE CLINICAL REFERENCE CENTRAL ACCESS & TRIAGE Introduction Pulmonary consulting services are organized through the Calgary Zone Pulmonary Central Access and Triage (PCAT). Working

More information

SARCOIDOSIS. Signs and symptoms associated with specific organ involvement can include the following:

SARCOIDOSIS. Signs and symptoms associated with specific organ involvement can include the following: SARCOIDOSIS Sarcoidosis is a disease that occurs when areas of inflammation develop in different organs of the body. Very small clusters of inflammation, called granulomas, are seen with sarcoidosis. They

More information

Idiopathic Interstitial Lung Disease

Idiopathic Interstitial Lung Disease KATHOLIEKE UNIVERSITEIT LEUVEN Faculty of Medicine Idiopathic Interstitial Lung Disease JA Verschakelen, W De Wever Department of Radiology, University Hospitals Leuven, Belgium Goals... To clarify the

More information

High-Resolution Lung CT:

High-Resolution Lung CT: High-Resolution Lung CT: Key Findings and What They Mean 2 W. Richard Webb MD Key HRCT Findings of Lung Disease interlobular septal thickening honeycombing irregular reticular opacities traction bronchiectasis

More information

Cystic Lung Diseases. Melissa Price Gillian Lieberman, MD Advanced Radiology Clerkship Beth Israel Deaconess Medical Center November, 2008

Cystic Lung Diseases. Melissa Price Gillian Lieberman, MD Advanced Radiology Clerkship Beth Israel Deaconess Medical Center November, 2008 Cystic Lung Diseases Melissa Price Gillian Lieberman, MD Advanced Radiology Clerkship Beth Israel Deaconess Medical Center November, 2008 How do we define a cyst of the lung? Hansell DM, Bankier AA, MacMahon

More information

Defending the Rest Basics on Lung Cancer, Other Cancers and Asbestosis: Review of the B-Read and Pulmonary Function Testing

Defending the Rest Basics on Lung Cancer, Other Cancers and Asbestosis: Review of the B-Read and Pulmonary Function Testing Defending the Rest Basics on Lung Cancer, Other Cancers and Asbestosis: Review of the B-Read and Pulmonary Function Testing ASBESTOSIS November 2013 Bruce T. Bishop Lucy L. Brandon Willcox & Savage 440

More information

Differentiating Asthma from COPD: Role of History, Physical Examination, Laboratory Studies, and Lung Function Testing

Differentiating Asthma from COPD: Role of History, Physical Examination, Laboratory Studies, and Lung Function Testing Differentiating Asthma from COPD: Role of History, Physical Examination, Laboratory Studies, and Lung Function Testing Stephen P Peters, MD, PhD, FAAAAI Professor of Medicine, Pediatrics and Translational

More information

Online supplements are not copyedited prior to posting.

Online supplements are not copyedited prior to posting. Functional Impact of a Spectrum of Interstitial Lung Abnormalities in Rheumatoid Arthritis Tracy J. Doyle, MD, MPH; Paul F. Dellaripa, MD; Kerri Batra, MD; Michelle L. Frits, BA; Christine K. Iannaccone,

More information

Recurrent or Persistent Pneumonia

Recurrent or Persistent Pneumonia Recurrent or Persistent Pneumonia Lower Respiratory Tract Dr T Avenant Recurrent or Persistent Pneumonia Definitions Recurrent pneumonia more than two episodes of pneumonia in 18 months Persistent pneumonia

More information

September 2008 [KT 168] Sub. Code: 2063 M.D. DEGREE EXAMINATION Branch XVII Tuberculosis and Respiratory Diseases NON-TUBERCULOSIS CHEST DISEASES Common to Part II Paper II - (Old /New/Revised Regulations)

More information

Restrictive vs. Obstructive Disease (Dedicated to my good friend Joe Walsh)

Restrictive vs. Obstructive Disease (Dedicated to my good friend Joe Walsh) Restrictive vs. Obstructive Disease (Dedicated to my good friend Joe Walsh) The field of medicine has a long history of describing or classifying disease. Pulmonary disease is no different. Although there

More information

Rheumatoid arthritis (RA) is a systemic inflammatory disorder which has pleuroparenchymal

Rheumatoid arthritis (RA) is a systemic inflammatory disorder which has pleuroparenchymal Introduction: Rheumatoid arthritis (RA) is a systemic inflammatory disorder which has pleuroparenchymal involvement with varied manifestations which includes organizing pneumonia, interstitial fibrosis,

More information

Chest Radiology 101: Back To The Basics

Chest Radiology 101: Back To The Basics Chest Radiology 101: Back To The Basics Brian Korotzer, MD Pulmonary and Critical Care Medicine Kaiser Permanente, Bellflower Associate Clinical Professor of Medicine David Geffen School of Medicine at

More information

The Radiology of Tuberculosis

The Radiology of Tuberculosis The Radiology of Tuberculosis David Ashkin, M.D., F.C.C.P. Medical Director, Southeastern National Tuberculosis Center Medical Director, Florida Bureau of TB and Refugee Health Clinical Assistant Professor,

More information

Lung Opacity: Atelectasis, Consolidation, Ground Glass Opacity, and Mosaic Attenuation

Lung Opacity: Atelectasis, Consolidation, Ground Glass Opacity, and Mosaic Attenuation Lung Opacity: Atelectasis, Consolidation, Ground Glass Opacity, and Mosaic Attenuation Gautham P. Reddy, MD, MPH University of Washington Learning Objectives Identify lobar or rounded atelectasis Describe

More information

MEDICAL REPORT MEDICAL HISTORY QUESTIONS

MEDICAL REPORT MEDICAL HISTORY QUESTIONS MEDICAL HISTORY QUESTIONS PAGE 1 OF 7 IF YOUR ANSWER IS YES TO ANY OF THE FOLLOWING QUESTIONS, PLEASE PROVIDE ADDITIONAL INFORMATION INCLUDING: DIAGNOSIS, DATE, AND TREATMENT (INCLUDING MEDICATIONS AND/OR

More information

written by Harvard Medical School COPD It Can Take Your Breath Away www.patientedu.org/copd

written by Harvard Medical School COPD It Can Take Your Breath Away www.patientedu.org/copd written by Harvard Medical School COPD It Can Take Your Breath Away www.patientedu.org/copd What Is COPD? COPD stands for chronic obstructive pulmonary disease. There are two major diseases included in

More information

Diagnosis & Treatment Of Cough

Diagnosis & Treatment Of Cough Diagnosis & Treatment Of Cough a.diagnosis : - Details History - Physical Examination - Investigation b. Treatment of cough Detail history provides valuables clues for etiology of the cough - Acute or

More information

Dermatomyositis and interstitial lung disease. Asmin Tulpule, HMS III November 16, 2009 Core Radiology Clerkship

Dermatomyositis and interstitial lung disease. Asmin Tulpule, HMS III November 16, 2009 Core Radiology Clerkship Dermatomyositis and interstitial lung disease Asmin Tulpule, HMS III November 16, 2009 Core Radiology Clerkship Agenda Presentation of our patient Menu of radiologic tests Basics of interstitial lung disease

More information

Nonspecific Interstitial Pneumonia

Nonspecific Interstitial Pneumonia 8 Nonspecific Interstitial Pneumonia The recognition that lung biopsy samples from some patients with idiopathic interstitial disease do not fit into any well-defined histological patterns of idiopathic

More information

Idiopathic Pulmonary Fibrosis

Idiopathic Pulmonary Fibrosis Idiopathic Pulmonary Fibrosis What is Idiopathic Pulmonary Fibrosis? Idiopathic pulmonary fibrosis (IPF) is a condition that causes persistent and progressive scarring of the tiny air sacs (alveoli) in

More information

COPD It Can Take Your Breath Away www.patientedu.org

COPD It Can Take Your Breath Away www.patientedu.org written by Harvard Medical School COPD It Can Take Your Breath Away www.patientedu.org What Is COPD? COPD stands for chronic obstructive pulmonary disease. There are 2 major diseases included in COPD:

More information

Defending Lung Cancer Claims A Primer for Young Lawyers

Defending Lung Cancer Claims A Primer for Young Lawyers Defending Lung Cancer Claims A Primer for Young Lawyers Michael W. Drumke Swanson, Martin & Bell, LLP 330 North Wabash Avenue, Suite 3300 Chicago, IL 60611-3604 (312) 321-9100 (312) 321-0990 mdrumke@smbtrials.com

More information

Jim Allen, MD Professor of Internal Medicine Division of Pulmonary & Critical Care Medicine Ohio State University Medical Center

Jim Allen, MD Professor of Internal Medicine Division of Pulmonary & Critical Care Medicine Ohio State University Medical Center Interstitial Lung Disease Nitin Bhatt, MD Assistant Professor of Internal Medicine Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine Ohio State University Medical Center Case #1 Interstitial

More information

HEALTH CARE FOR EXPOSURE TO ASBESTOS. 2010 The SafetyNet Centre for Occupational Health and Safety Research Memorial University www.safetynet.mun.

HEALTH CARE FOR EXPOSURE TO ASBESTOS. 2010 The SafetyNet Centre for Occupational Health and Safety Research Memorial University www.safetynet.mun. HEALTH CARE FOR PATIENTS WITH EXPOSURE TO ASBESTOS 2010 The SafetyNet Centre for Occupational Health and Safety Research Memorial University www.safetynet.mun.ca HEALTH CARE FOR PATIENTS WITH EXPOSURE

More information

Disease/Illness GUIDE TO ASBESTOS LUNG CANCER. What Is Asbestos Lung Cancer? www.simpsonmillar.co.uk Telephone 0844 858 3200

Disease/Illness GUIDE TO ASBESTOS LUNG CANCER. What Is Asbestos Lung Cancer? www.simpsonmillar.co.uk Telephone 0844 858 3200 GUIDE TO ASBESTOS LUNG CANCER What Is Asbestos Lung Cancer? Like tobacco smoking, exposure to asbestos can result in the development of lung cancer. Similarly, the risk of developing asbestos induced lung

More information

Chest X-rays: Author Dr R Katz. Chest X-rays: Programme 3

Chest X-rays: Author Dr R Katz. Chest X-rays: Programme 3 Chest X-rays: Programme 3 In the previous tutorial we looked at the different causes and appearances of increased shadowing in the lungs. I will start this tutorial by briefly looking at the causes of

More information

Neoplasms of the LUNG and PLEURA

Neoplasms of the LUNG and PLEURA Neoplasms of the LUNG and PLEURA 2015-2016 FCDS Educational Webcast Series Steven Peace, BS, CTR September 19, 2015 2015 Focus o Anatomy o SSS 2000 o MPH Rules o AJCC TNM 1 Case 1 Case Vignette HISTORY:

More information

Pulmonary Complications from Lung Cancer Treatment, Part 1: Chemotherapy-Induced Pneumonitis by Dr. Gerard Silvestri, Medical University of South Carolina Dr. West: Hello, and welcome to our webinar with

More information

Basic Chest X-ray Interpretation Programme 2

Basic Chest X-ray Interpretation Programme 2 Basic Chest X-ray Interpretation Programme 2 In this second chest x-ray tutorial I will now start to look at some of the more commonly encountered pathologies. I have split this up into abnormalities involving

More information

Cystic Fibrosis. Cystic fibrosis affects various systems in children and young adults, including the following:

Cystic Fibrosis. Cystic fibrosis affects various systems in children and young adults, including the following: Cystic Fibrosis What is cystic fibrosis? Cystic fibrosis (CF) is an inherited disease characterized by an abnormality in the glands that produce sweat and mucus. It is chronic, progressive, and is usually

More information

Idiopathic Pulmonary Fibrosis (IPF) Research

Idiopathic Pulmonary Fibrosis (IPF) Research Idiopathic Pulmonary Fibrosis (IPF): Why Early Referral is Critical Even if Your Patient is Not Eligible for a Clinical Trial Idiopathic Pulmonary Fibrosis (IPF) Research Management of IPF requires a confident

More information

Pneumocystis Jiroveci: Imaging Findings on HRCT

Pneumocystis Jiroveci: Imaging Findings on HRCT Pneumocystis Jiroveci: Imaging Findings on HRCT Poster No.: C-2491 Congress: ECR 2015 Type: Educational Exhibit Authors: R. E. Correa Soto, J. M. Fernandez Garcia-Hierro, M. J. Martín 1 1 2 1 1 Sánchez,

More information

Occupational Lung Disease. David Perlman, MD

Occupational Lung Disease. David Perlman, MD Occupational Lung Disease David Perlman, MD What causes occupational lung diseases? Breathing bad stuff into your lung Mechanism of particle deposition Large particles (>0.5μM) Impaction Gravitational

More information

Asbestos Disease: An Overview for Clinicians Asbestos Exposure

Asbestos Disease: An Overview for Clinicians Asbestos Exposure Asbestos Asbestos Disease: An Overview for Clinicians Asbestos Exposure Asbestos: A health hazard Exposure to asbestos was a major occupational health hazard in the United States. The first large-scale

More information

USC Pediatric Residency Program Quality Improvement Pre-Program Self Assessment

USC Pediatric Residency Program Quality Improvement Pre-Program Self Assessment USC Pediatric Residency Program Quality Improvement Pre-Program Self Assessment 1. Have you had previous experience in quality improvement (QI)? Yes No 2. How many formal quality improvement projects have

More information

2011 Radiology Diagnosis Coding Update Questions and Answers

2011 Radiology Diagnosis Coding Update Questions and Answers 2011 Radiology Diagnosis Coding Update Questions and Answers How can we subscribe to the Coding Clinic for ICD-9 guidelines and updates? The American Hospital Association publishes this quarterly newsletter.

More information

Pulmonary Complications of Cancer Therapy. Marc B. Feinstein, MD Pulmonary Division Memorial Sloan-Kettering Cancer Center

Pulmonary Complications of Cancer Therapy. Marc B. Feinstein, MD Pulmonary Division Memorial Sloan-Kettering Cancer Center Pulmonary Complications of Cancer Therapy Marc B. Feinstein, MD Pulmonary Division Memorial Sloan-Kettering Cancer Center Tobacco About 85% of lung cancers occur in current/former smokers. Tobacco causes

More information

X-Rays. Interpretation of Chest Radiographs. X-ray Absorption. Tissue Density

X-Rays. Interpretation of Chest Radiographs. X-ray Absorption. Tissue Density X-Rays Interpretation of Chest Radiographs Reynard McDonald, MD Medical Director NJMS Global Tuberculosis Institute When x-rays are produced and directed toward the patient, they may act in three basic

More information

Primary -Benign - Malignant Secondary

Primary -Benign - Malignant Secondary TUMOURS OF THE LUNG Primary -Benign - Malignant Secondary The incidence of lung cancer has been increasing almost logarithmically and is now reaching epidemic levels. The overall cure rate is very low

More information

Non-Resolving Consolidation

Non-Resolving Consolidation Non-Resolving Consolidation Archana Laroia, MD Usual course of pneumonia -subjective improvement within three to five days of treatment. Archana Laroia, MD University of Iowa Hospitals and Clincs, Iowa

More information

HOW TO READ A CHEST X-RAY

HOW TO READ A CHEST X-RAY The Radiology of TB Michael Lauzardo, MD MSc Director, Southeastern National Tuberculosis Center Chief, Infectious Diseases and Global Medicine University of Florida Objectives How to read a Chest X-Ray

More information

Influenza (Flu) Influenza is a viral infection that may affect both the upper and lower respiratory tracts. There are three types of flu virus:

Influenza (Flu) Influenza is a viral infection that may affect both the upper and lower respiratory tracts. There are three types of flu virus: Respiratory Disorders Bio 375 Pathophysiology General Manifestations of Respiratory Disease Sneezing is a reflex response to irritation in the upper respiratory tract and is associated with inflammation

More information

Interstitial Lung Diseases ACOI Board Review 2013

Interstitial Lung Diseases ACOI Board Review 2013 Interstitial Lung Diseases ACOI Board Review 2013 Thomas F. Morley, DO, FACOI, FCCP, FAASM Professor of Medicine Director of the Division of Pulmonary, Critical Care and Sleep Medicine UMDNJ-SOM Restrictive

More information

INTERSTITIAL LUNG DISEASE Paul F. Simonelli, MD, Ph.D.

INTERSTITIAL LUNG DISEASE Paul F. Simonelli, MD, Ph.D. INTERSTITIAL LUNG DISEASE Paul F. Simonelli, MD, Ph.D. Definition: Interstitial lung disease (ILD) refers to a broad range of conditions that have common clinical, physiological, and radiological features.

More information

PARTICLE SIZE AND CHEMISTRY:

PARTICLE SIZE AND CHEMISTRY: Pneumoconioses LW/Please note: This information is additional to Davidson s Principles and Practice of Medicine. /Hierdie inligting is aanvullend tot Davidson s Principles and Practice of Medicine. Pneumoconioses

More information

Interpretation of Pulmonary Function Tests

Interpretation of Pulmonary Function Tests Interpretation of Pulmonary Function Tests Dr. Sally Osborne Cellular & Physiological Sciences University of British Columbia Room 3602, D.H Copp building 604 822-3421 sally.osborne@ubc.ca www.sallyosborne.com

More information

Department of Surgery

Department of Surgery What is emphysema? 2004 Regents of the University of Michigan Emphysema is a chronic disease of the lungs characterized by thinning and overexpansion of the lung-like blisters (bullae) in the lung tissue.

More information

LYMPHOMA IN DOGS. Diagnosis/Initial evaluation. Treatment and Prognosis

LYMPHOMA IN DOGS. Diagnosis/Initial evaluation. Treatment and Prognosis LYMPHOMA IN DOGS Lymphoma is a relatively common cancer in dogs. It is a cancer of lymphocytes (a type of white blood cell) and lymphoid tissues. Lymphoid tissue is normally present in many places in the

More information

CHEST IMAGING RADIOLOGY FUNDAMENTALS: UNDERSTANDING THE CHEST X- RAY RADIOGRAPHIC DENSITIES. Hounsfield Units 10/15/2013

CHEST IMAGING RADIOLOGY FUNDAMENTALS: UNDERSTANDING THE CHEST X- RAY RADIOGRAPHIC DENSITIES. Hounsfield Units 10/15/2013 CHEST IMAGING RADIOLOGY FUNDAMENTALS: UNDERSTANDING THE CHEST X- RAY RADIOGRAPHIC DENSITIES What are the different basic radiographic densities? Density Characteristics 1. Metal 2. Bone 3. Soft Tissue

More information

Interstitial lung disease in a rheumatic electrician

Interstitial lung disease in a rheumatic electrician Interstitial lung disease in a rheumatic electrician Case history The case presented here concerns a male, born in 1931, who was an electrician for 34 years. He had frequent and close contact with asbestos,

More information

Service Specification

Service Specification Service Specification Spirometry in Primary Care Date: February 2011 Document Reference: Service Specification (V4.0) Contents: Section Page 1 Definition of service 3 2 Training 4 3 Reporting / Monitoring

More information

Assessment of pulmonary function in rheumatoid arthritis patients attending Rheumatology Clinics in Nairobi

Assessment of pulmonary function in rheumatoid arthritis patients attending Rheumatology Clinics in Nairobi 1 College of Health Sciences, University of Nairobi, Nairobi, Kenya 2 Kenyatta National Hospital, Nairobi, Kenya 3 KAPTLD, Nairobi, Kenya Corresponding author: Dr. I. Biomdo, Department of Internal Medicine,

More information

Preoperative Laboratory and Diagnostic Studies

Preoperative Laboratory and Diagnostic Studies Preoperative Laboratory and Diagnostic Studies Preoperative Labratorey and Diagnostic Studies The concept of standardized testing in all presurgical patients regardless of age or medical condition is no

More information

2011 NTP Paediatric guidelines update- final draft

2011 NTP Paediatric guidelines update- final draft Childhood TB Investigation and management of children suspected to have tuberculosis (TB) or who are close contacts of a TB case (sputum smear positive or negative) Key facts Children who are close contacts

More information

Radiological Findings in BO

Radiological Findings in BO Radiological Findings in BO BO-Meeting 2016 Schloss Johannisberg Geisenheim - Rheingau Germany Dr. Simon Martin Department of Diagnostic and Interventional Radiology University Hospital Frankfurt Bronchiolitis

More information

Early Detection of Lung Cancer. Information for General Practitioners

Early Detection of Lung Cancer. Information for General Practitioners Early Detection of Lung Cancer Information for General Practitioners Produced By Clare de rmanville Principle Consultant Angela Tod Principle Research Fellow Samantha Jewell Senior Lecturer Elaine Brookes

More information

Spirometry. Sonia Munde. Senior Respiratory Care Physiologist Adult Respiratory Care & Rehab Team Barts Health

Spirometry. Sonia Munde. Senior Respiratory Care Physiologist Adult Respiratory Care & Rehab Team Barts Health Spirometry Sonia Munde Senior Respiratory Care Physiologist Adult Respiratory Care & Rehab Team Barts Health COPD Definition.airflow obstruction is usually progressive, not fully reversible and does not

More information

Western States Pediatric Pulmonary Case Conference

Western States Pediatric Pulmonary Case Conference Western States Pediatric Pulmonary Case Conference Sunil Kamath MD 4-20-11 Mentor: Daneli Salinas MD History of Present Illness 8 year old African American female with a history of chronic cough for 2

More information

There are a number of other carcinogens (cancer causing agents) that are believed to be associated with lung cancer, and are reviewed elsewhere.

There are a number of other carcinogens (cancer causing agents) that are believed to be associated with lung cancer, and are reviewed elsewhere. Lung Cancer What is cancer? First, some background on the way the body is built. Organs, like the heart, liver, and lung, are made up of tissues, such as blood vessels and muscle. Tissues, in turn, are

More information

NURS 821 Alterations in the Musculoskeletal System. Rheumatoid Arthritis. Type III Hypersensitivity Response

NURS 821 Alterations in the Musculoskeletal System. Rheumatoid Arthritis. Type III Hypersensitivity Response NURS 821 Alterations in the Musculoskeletal System Margaret H. Birney PhD, RN Lecture 12 Part 2 Joint Disorders (cont d) Rheumatoid Arthritis Definition: Autoimmune disorder occurring in genetically sensitive

More information

CERVICAL MEDIASTINOSCOPY WITH BIOPSY

CERVICAL MEDIASTINOSCOPY WITH BIOPSY INFORMED CONSENT INFORMATION ADDRESSOGRAPH DATA CERVICAL MEDIASTINOSCOPY WITH BIOPSY You have decided to have an important procedure and we appreciate your selection of UCLA Healthcare to meet your needs.

More information

THE MUSCLE AND CARDIOVASCULAR SYSTEM

THE MUSCLE AND CARDIOVASCULAR SYSTEM THE MUSCLE AND CARDIOVASCULAR SYSTEM The focus of this week s lab will be pathology of the cardiovascular system. The cardiovascular system is composed of the heart and its associated structures as well

More information

Immune-Mediated Diseases. In a Nutshell

Immune-Mediated Diseases. In a Nutshell Immune-Mediated Diseases In a Nutshell Objectives Describe the epidemiology, clinical presentation, pathogenesis and pathologic changes of autoimmune diseases, including lupus erythematosis, rheumatoid

More information

An overview of blood tests in respiratory illness. Dr John Cullen Consultant in Internal and Respiratory Medicine Tallaght Hospital

An overview of blood tests in respiratory illness. Dr John Cullen Consultant in Internal and Respiratory Medicine Tallaght Hospital An overview of blood tests in respiratory illness Dr John Cullen Consultant in Internal and Respiratory Medicine Tallaght Hospital Pneumonia Pneumonia Full blood count (FBC) WCC Usually high (but may

More information

Chronic Renal Disease (CRD)

Chronic Renal Disease (CRD) What do kidneys normally do? The kidneys function on many levels to maintain homeostasis (internal balance) in the body. The kidneys make urine as well as determining how concentrate or dilute the urine

More information

Pericardial Effusion. By Nancy Liao

Pericardial Effusion. By Nancy Liao Pericardial Effusion By Nancy Liao 24 y/o female with history of metatropic dysplasia presents with 2 weeks of dry progressive cough, dyspnea, increased work of breathing, somnolence, exhaustion, and diffuse

More information

Arterial Blood Gas Case Questions and Answers

Arterial Blood Gas Case Questions and Answers Arterial Blood Gas Case Questions and Answers In the space that follows you will find a series of cases that include arterial blood gases. Each case is then followed by an explanation of the acid-base

More information

Liver Function Essay

Liver Function Essay Liver Function Essay Name: Quindoline Ntui Date: April 20, 2009 Professor: Dr. Danil Hammoudi Class: Anatomy and Physiology 2 Liver function The human body consist of many highly organize part working

More information

Arthritis in Children: Juvenile Rheumatoid Arthritis By Kerry V. Cooke

Arthritis in Children: Juvenile Rheumatoid Arthritis By Kerry V. Cooke Reading Comprehension Read the following essay on juvenile rheumatoid arthritis. Then use the information in the text to answer the questions that follow. Arthritis in Children: Juvenile Rheumatoid Arthritis

More information

Normal CT scan of the chest

Normal CT scan of the chest Normal CT scan of the chest Heart with left and right ventricle showing up lighter (contrast dye) Breast tissue Breast bone (sternum) Breast tissue Left lung (dark area) Right lung (dark area) Rib Main

More information

Pulmonary Patterns VMA 976

Pulmonary Patterns VMA 976 Pulmonary Patterns VMA 976 PULMONARY PATTERNS Which pulmonary patterns are commonly described in veterinary medicine? PULMONARY PATTERNS Normal Alveolar Interstitial Structured/Nodular Unstructured Bronchial

More information

CHAPTER 11 DISEASES OF THE DIGESTIVE SYSTEM (K00-K95) April MVP Health Care, Inc.

CHAPTER 11 DISEASES OF THE DIGESTIVE SYSTEM (K00-K95) April MVP Health Care, Inc. DISEASES OF THE DIGESTIVE SYSTEM (K00-K95) April 2014 2014 MVP Health Care, Inc. CHAPTER SPECIFIC CATEGORY CODE BLOCKS K00-K14 Diseases of oral cavity and salivary glands K20-K31 Diseases of esophagus,

More information

Lung Cancer. This reference summary will help you better understand lung cancer and the treatment options that are available.

Lung Cancer. This reference summary will help you better understand lung cancer and the treatment options that are available. Lung Cancer Introduction Lung cancer is the number one cancer killer of men and women. Over 165,000 people die of lung cancer every year in the United States. Most cases of lung cancer are related to cigarette

More information

CT scans and IV contrast (radiographic iodinated contrast) utilization in adults

CT scans and IV contrast (radiographic iodinated contrast) utilization in adults CT scans and IV contrast (radiographic iodinated contrast) utilization in adults At United Radiology Group, a majority of CT exams are performed either with IV contrast or without while just a few exams

More information

1. ML is a 14-month-old girl diagnosed with acute otitis media. She presented to the pediatric

1. ML is a 14-month-old girl diagnosed with acute otitis media. She presented to the pediatric 1 Chapter 72, Self-Assessment Questions 1. ML is a 14-month-old girl diagnosed with acute otitis media. She presented to the pediatric clinic today with a fever of 102.4 F (39.1 C) and tugging of her right

More information

General Thoracic Surgery ICD9 to ICD10 Crosswalks. C34.11 Malignant neoplasm of upper lobe, right bronchus or lung

General Thoracic Surgery ICD9 to ICD10 Crosswalks. C34.11 Malignant neoplasm of upper lobe, right bronchus or lung ICD-9 Code ICD-9 Description ICD-10 Code ICD-10 Description 150.3 Malignant neoplasm of upper third of esophagus C15.3 Malignant neoplasm of upper third of esophagus 150.4 Malignant neoplasm of middle

More information

Diaphragm Paralysis. Chadrick E. Denlinger, MD. Management of 5 consecutive cases that I was referred

Diaphragm Paralysis. Chadrick E. Denlinger, MD. Management of 5 consecutive cases that I was referred Diaphragm Paralysis Management of 5 consecutive cases that I was referred Chadrick E. Denlinger, MD Assistant Professor of Surgery Medical University of South Carolina 54 year old previously healthy man

More information

Pneumocystis carinii Pneumonia in an Untreated Patient with HIV. a complaint of worsening shortness of breath over the previous 4-6 weeks.

Pneumocystis carinii Pneumonia in an Untreated Patient with HIV. a complaint of worsening shortness of breath over the previous 4-6 weeks. Pneumocystis carinii Pneumonia in an Untreated Patient with HIV Gary is a 43 year old gay white man who presents to your office for the first time with a complaint of worsening shortness of breath over

More information

Mediastinoscopy: Lymph Node Biopsy

Mediastinoscopy: Lymph Node Biopsy Mediastinoscopy: Lymph Node Biopsy When You Need Mediastinoscopy Your doctor thinks that you have a lung problem. Something suspicious may have been found on a test. Your doctor now recommends that you

More information

Asbestos and your lungs

Asbestos and your lungs This information describes what asbestos is and the lung conditions that are caused by exposure to it. It also includes information about what to do if you have been exposed to asbestos, and the benefits

More information

TUBERCULOSIS PLEURAL EFFUSION - MANAGEMENT

TUBERCULOSIS PLEURAL EFFUSION - MANAGEMENT TUBERCULOSIS PLEURAL EFFUSION - MANAGEMENT Introduction : ETB 15-20% Pleural effusion 20% in non HIV Under reporting because of AFB negative in fluid In HIV patients: EPTB 20% PTB + EPTB 50% Pleural Effusion

More information

Occupational Lung Disease. SS Visser Internal Medicine UP

Occupational Lung Disease. SS Visser Internal Medicine UP Occupational Lung Disease SS Visser Internal Medicine UP Classification Anorganic ( mineral ) dust/pneumoconiosis Fibrogenic - silica, asbestos, talc, silicates Non-fibrogenic - Fe, barium, tin Immunologic/Pharmcologic

More information

GFR (Glomerular Filtration Rate) A Key to Understanding How Well Your Kidneys Are Working

GFR (Glomerular Filtration Rate) A Key to Understanding How Well Your Kidneys Are Working GFR (Glomerular Filtration Rate) A Key to Understanding How Well Your Kidneys Are Working www.kidney.org National Kidney Foundation's Kidney Disease Outcomes Quality Initiative Did you know that the National

More information

Fungal Infections: When Broad Spectrum Antibiotics Aren t Broad Enough

Fungal Infections: When Broad Spectrum Antibiotics Aren t Broad Enough Fungal Infections: When Broad Spectrum Antibiotics Aren t Broad Enough Minor fungal infections are encountered often in the ED, but fungal infections can also be much more than a nuisance. Life-threatening

More information

Chronic Kidney Disease

Chronic Kidney Disease Chronic Kidney Disease Introduction Chronic kidney disease, also known as CKD, is the gradual loss of kidney function. When CKD reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes

More information

Summary of the risk management plan (RMP) for Accofil (filgrastim)

Summary of the risk management plan (RMP) for Accofil (filgrastim) EMA/475472/2014 Summary of the risk management plan (RMP) for Accofil (filgrastim) This is a summary of the risk management plan (RMP) for Accofil, which details the measures to be taken in order to ensure

More information

Documenting & Coding. Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC

Documenting & Coding. Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC Documenting & Coding Chronic Obstructive Pulmonary Disease (COPD) Presented by: David S. Brigner, MLA, CPC Sr. Provider Training & Development Consultant Professional Profile David Brigner currently performs

More information

CPT codes are for information only; consult your payer organization for reimbursement information.

CPT codes are for information only; consult your payer organization for reimbursement information. CPT codes are for information only; consult your payer organization for reimbursement information. Coverage for Spirometry/Oximetry Spirometry is a component of pulmonary function testing (PFTs). PFTs

More information

Mesothelioma. 1995-2013, The Patient Education Institute, Inc. www.x-plain.com ocft0101 Last reviewed: 03/21/2013 1

Mesothelioma. 1995-2013, The Patient Education Institute, Inc. www.x-plain.com ocft0101 Last reviewed: 03/21/2013 1 Mesothelioma Introduction Mesothelioma is a type of cancer. It starts in the tissue that lines your lungs, stomach, heart, and other organs. This tissue is called mesothelium. Most people who get this

More information

Community Acquired Pneumonia

Community Acquired Pneumonia Community Acquired Pneumonia Client Education Booklet Client means patient/client/resident What is Pneumonia? Pneumonia is an inflammation of the lungs caused by infection. What Pneumonia does When you

More information

Denied fevers, weight loss, visual or neurologic deficits. Denied sick contacts including anyone with tuberculosis

Denied fevers, weight loss, visual or neurologic deficits. Denied sick contacts including anyone with tuberculosis Is that contagious? HPI: Previously healthy 16 y/o male on return from a 4 year stay in Nigeria presented with a rash on his face, back and upper and lower extremities that had become more prominent over

More information

Restrictive lung diseases

Restrictive lung diseases Restrictive lung diseases Characterized by reduced compliance of the lung. Prominent changes in the interstitium (interstitial lung disease). Important signs and symptoms: - Dyspnea. - Hypoxia. - With

More information

Idiopathic Pulmonary Fibrosis and You Patient Education Guide

Idiopathic Pulmonary Fibrosis and You Patient Education Guide Idiopathic Pulmonary Fibrosis and You Patient Education Guide A M E R I C A N C O L L E G E O F C H E S T P H Y S I C I A N S A N D T H E C H E S T F O U N D A T I O N Idiopathic Pulmonary Fibrosis and

More information

TAKING CARE OF YOUR RHEUMATOID ARTHRITIS

TAKING CARE OF YOUR RHEUMATOID ARTHRITIS TAKING CARE OF YOUR RHEUMATOID ARTHRITIS RHEUMATOID ARTHRITIS (RA) FAST FACTS What is Rheumatoid Arthritis? Rheumatoid arthritis (RA) is a chronic disease that can affect your ability to function and be

More information

Tests. Pulmonary Functions

Tests. Pulmonary Functions Pulmonary Functions Tests Static lung functions volumes Dynamic lung functions volume and velocity Dynamic Tests Velocity dependent on Airway resistance Resistance of lung tissue to change in shape Dynamic

More information

Complete blood count. Definition. 1

Complete blood count. Definition.  1 Complete blood count Definition A complete blood count (CBC) test measures the following: The number of red blood cells (RBCs) The number of white blood cells (WBCs) The total amount of hemoglobin in the

More information

Respiratory Conditions in Malaysian Asbestos Cement Workers

Respiratory Conditions in Malaysian Asbestos Cement Workers ORIGINAL ARTICLE Respiratory Conditions in Malaysian Asbestos Cement Workers H H Lim, FAFOM*, KG Rampa!, PhD**, S ]oginder, FRCR***, C M Abu Bakar, MSc****, K H Chan, MBBS*, T N Vivek, MD* Mediviron Consultants

More information

Diagnosis and management of community acquired pneumonia in children

Diagnosis and management of community acquired pneumonia in children Diagnosis and management of community acquired pneumonia in children an Robinson Relationships with commercial interests: Grants/Research Support: NIH, Pfizer Speakers Bureau/Honoraria: None Consulting

More information