What CT finding is characteristic of UIP?
Subpleural reticulation with honeycombing ⭐
+ traction bronchiectasis
+ apicobasal gradient with basal and subpleural predominance
What are classic clinical features of UIP?
Progressive dyspnoea, clubbing, inspiratory crackles
UIP / IPF:
progressive dyspnoea
clubbing ⭐
velcro crackles
CT：
subpleural
basal predominance
honeycombing ⭐
UIP vs hypersensitivity pneumonitis — key CT difference?
A patient with bird exposure and ILD — what determines diagnosis?
UIP: honeycombing
HP: ground-glass opacities ⭐
CT pattern, not exposure history ⭐
Does hypersensitivity pneumonitis usually cause clubbing?
No ⚠️ (UIP/IPF: clubbing)
Name the 5 major causes of interstitial lung disease.
Most common idiopathic interstitial pneumonia?
Idiopathic, connective tissue disease, environmental/occupational, drug-induced, others
Idiopathic pulmonary fibrosis (UIP)
Name 4 drugs that cause ILD.
Amiodarone, methotrexate, bleomycin, nitrofurantoin ⭐
- acute simple cystitis without MDR RFs, first-line: nitrofurantoin monohydrate/macrocrystals, trimethoprim-sulfamethoxazole, fosfomycin, or pivmecillinam)
What exposure is associated with hypersensitivity pneumonitis?
Birds and mould (mold) ⭐
CT finding in hypersensitivity pneumonitis?
Ground-glass opacities
Typical imaging feature of sarcoidosis?
Hilar lymphadenopathy with nodularity
Which ILD is associated with smoking and cyst formation?
Langerhans cell histiocytosis ⭐
👉 1️⃣ Honeycombing
👉 2️⃣ Ground-glass
👉 3️⃣ Nodules + hilar lymph nodes
👉 4️⃣ Cysts（smoker）
👉 = UIP（不用想）
👉 想：HP & NSIP
再看：
exposure → HP
autoimmune → NSIP
👉 = Sarcoidosis
👉 = Langerhans cell histiocytosis（LCH）
⭐ UIP / IPF
年長男性
progressive dyspnoea
⭐ clubbing
inspiratory crackles
⭐ HP
bird exposure（pigeon breeder）
mould / farming
❗通常沒有 clubbing
⭐ Sarcoidosis
年輕人
erythema nodosum
uveitis
bilateral hilar lymphadenopathy
⭐ LCH
smoker
young adult
pneumothorax（偶爾考）
❌ 陷阱 1：看到 exposure 就選 HP
👉 ❗錯
👉 正確：CT pattern > exposure
❌ 陷阱 2：ground-glass vs honeycombing
👉 Honeycombing = fibrosis = UIP（不可逆）
👉 Ground-glass = inflammation（可逆）
❌ 陷阱 3：clubbing
👉 有 clubbing → UIP
👉 沒 clubbing → 想 HP / NSIP
What is the inheritance pattern of cystic fibrosis?
Autosomal recessive ⭐
How do you estimate CF risk when one parent has an affected sibling?
Use conditional probability (2/3 carrier risk) ⭐
Where is the correct landmark for subclavian vein cannulation in obese patients?
2 cm below the midpoint of the clavicle and 1 cm laterally ⭐
1 and 0.5 in normla patients
