ILD - HP

Question 1

What type of hypersensitivity reaction is HP

Answer 1

3 or 4

Question 2

What HP organism is ax with Malt

Answer 2

Aspergillus clavatus

Question 3

Where is trichosporon cutaneum found

Answer 3

Dust

Question 4

Timeline for acute HP

Answer 4

4-8 hours after exposure

Sx can settle in 1-3 days after withdrawal from exposure

Question 5

Do you get clubbing HP

Answer 5

Rarely

Question 6

CXR findings Acute HP

Answer 6

Diffuse small 1-3mm nodules or infiltrates
GG
Apical sparing

Normal in 20%

Question 7

HRCT findings HP

Answer 7

patchy or diffuse lucency
mosaic attenuation

quickly normalises after antigen withdrawal

Question 8

CXR findings Chronic HP

Answer 8

Upper and mid zone reticulation

Reduced lung volumes

Question 9

HRCT findings chronic HP

Answer 9

Diffuse centrilobular nodules
GG
Mosaic attenuation
+- honeycombing, traction bronchiectasis

Question 10

PFT findings in HP

Answer 10

Restrictive or normal

Question 11

Neutrophils in HP

Answer 11

High

Question 12

BAL findings in HP

Answer 12

lymphocytosis

> 30% lymphocytes

Question 13

Lung biopsy findings in HP

Answer 13

bronchiocentric granulomatous lymphocytic pneumonitis

Question 14

What to do if unclear HP diagnosis post MDT

Answer 14

transbronchial cryobiopsy or surgical biopsy - if not fibrotic HP

Question 15

Factors ax with increased mortality in HP

Answer 15

Old smoking men
Genetic predisposition
Unable to identify antigen
Low FVC, DCLO
Decline in FVC
Lower BAL lymphcytosis
Presence or extent of fibrosis HRCT
UIP
Fibrotic NSIP on histo