what are the features of idiopathic pulmonary fibrosis?
progressive exertion dyspnea, bibasal fine end-inspiratory creps, dry cough, clubbing
what are the spirometry findings of IPF?
restrictive picture, [fev1 normal/decreased, FVC decreases, FEV1/FVC increased], reduced transfer factor
what are the CXR findings of IPF?
bilateral interstitial shadowing (small, irregular, peripheral opacities ‘ground glass’ which later progress to honeycombing
what are the features of sarcoidosis
acute: erythema nodosum, bilateral hilar lymphadenopathy, polyarthralgia
insidious: dyspnoea, non-productive cough, malaise, weight loss
uveitis
lupus pernio
hypercalcaemia
causes for upper zone lung fibrosis?
C : Coal workers pneumoconiosis
H : Histiocytosis
A: Ankylosing spondylittis
R: Radiation
T: TB
S: Silicosis / sarcoidosis
causes for lower zone fibrosis
IPF, SLE, drug induced eg amiodarone/bleomycin/methrotrexate, asbestosis
what are the common organisms present in patients with bronchiectasis?
haemophilus influenza (most common)
pseudomonas aeruginosa
klbesiella
streptococcus pneumonia
what type of lung infection is contraindicated to lung transplantation in CF patients?
Burkholderia cepacia
how is position of chest drain confirmed?
Positioning can be confirmed by aspiration of fluid from the drainage tubing, by ‘swinging’ of the fluid within the drain tubing when the patient inspires and on chest x-ray.
what is the management of a HAP?
non severe infections : oral co-amoxiclav
severe infections: IV Taz or IC third gen cephalospiron or IV meropemen
IF MRSA is suspected then add IV Vancomycin
what are the features of allergic bronchopulmonary aspergillosis?
bronchocontriction: wheeze, cough, dyspnoea, eosinophilia
what is the management of allergic bronchopulmonary aspergillosis?
oral glucocorticoids
itraconazole is second line
