Dr. Aninditee Das, Dr. Karen Geukers, and Dr. Marco Mura discuss pulmonary fibrosis, covering its history, pathology, management, treatment options, lung transplantation, and managing acute exacerbations in patients. The episode provides insights into the approach to patients with suspected pulmonary fibrosis.
Idiopathic pulmonary fibrosis diagnosis and treatment include chest imaging and medication interventions.
Deep dives
Understanding Pulmonary Fibrosis
Pulmonary fibrosis is a lung disease characterized by fibrosis of the interstitium, leading to stiffening and scarring of the lungs, hindering oxygen exchange. Various triggers like toxins or viruses can injure the lung's epithelial lining, causing fibroblasts to form scarring in the alveoli. This scarring results in progressive lung stiffness and impaired oxygen entry into the bloodstream.
Diagnosis and Management of IPF
Idiopathic pulmonary fibrosis (IPF) is a common form of pulmonary fibrosis with no known cause. Diagnosis involves chest X-rays showing reticular opacities and high-resolution CT scans revealing Usual Interstitial Pneumonia (UIP) pattern. Treatment includes using medications like perfenidone and nintedanib to slow disease progression, while supportive care involves oxygen therapy and pulmonary rehabilitation.
Acute Exacerbation of IPF
Patients with IPF may experience acute exacerbations marked by acute respiratory decline. Diagnosis involves CT scans showing acute changes superimposed on chronic UIP, excluding other causes like infection or heart failure. Treatment focuses on supportive care, oxygenation maintenance, and may include a trial of glucocorticoids, though only a portion of patients respond.
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Understanding and Managing Pulmonary Fibrosis, with a Focus on IPF
In this episode we cover the approach to a patient with suspected pulmonary fibrosis. This episode discusses history, physical exam, treatments and management of acute exacerbations.
Written by: Dr. Aninditee Das (Internal Medicine Resident) Reviewed by: Dr. Karen Geukers (Internal Medicine) and Dr. Marco Mura (Respirology)