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Respiratory Exam

Interstitial Lung Disease



  • Signs of Interstitial Lung Disease

  • General Signs

  • Dry cough
  • Cyanosis
  • Reduced chest expansion
  • Crepitations - fine, end-expiratory
  • Signs Suggesting a Cause

  • Symmetric arthropathy (rheumatoid arthritis)
  • Skin thickening (scleroderma)
  • Lymphadenopathy (sarcoidosis)
  • Signs of Complications

  • Cor pulmonale - raised JVP, ascites, pleural effusions, peripheral oedema
  • Pulmonary hypertension - prominent a wave, parasternal heave, loud / palpable P2


  • Causes of Interstitial Lung Disease

  • ILD of Known Association

  • Connective tissue disease - rheumatoid arthritis, scleroderma, systemic lupus erythematosus, Sjogren's syndrome, polymyositis / dermatomyositis
  • Medications - methotrexate, nitrofurantoin, bleomycin
  • Occupational exposure - silicosis, asbestosis
  • Granulomatous ILD

  • Sarcoidosis
  • Hypersensitivity pneumonitis
  • Idiopathic Interstitial Pneumonias

  • Idiopathic pulmonary fibrosis
  • Others - idiopathic non-specific interstitial pneumonia, acute interstitial pneumonia, cryptogenic organising pneumonia, lymphocytic interstitial pneumonia, desquamative interstitial pneumonia


  • Complications of Interstitial Lung Disease

  • Acute exacerbation of ILD
  • Cor pulmonale
  • Pulmonary hypertension
  • Lung cancer
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