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ILD ´ëÀå°æ Á¤¸®

1. ILD¸¦ À¯¹ßÇÏ´Â ´ëÇ¥Àû Ç×»ýÁ¦: "NSIPC"

Nitrofurantoin, Sulfonamide, INH, Penicillin, Cephalosporin

2. D-penicillamine¸¸ÀÌ BOOPÀ» ÀÏÀ¸Å²´Ù.

3. ±Þ¼ºÁõ»ó°ú ¹ß¿­À» º¸ÀÌ´Â ILD?

acute eosinophilic pneumonia, hypersensitivity pneumonitis, drug-induced ILD

BOOP, acute interstitial pneumonia, acute immunologic pneumonia

4. ILD¿¡¼­ steroid¿¡ ¹ÝÀÀÀÌ ÁÁÀº °æ¿ì

sarcoidosis, hypersensitivity pneumonitis, BOOP, chronic eosinophilic pneumonia

5. Æó¾ÏÀÌ Àß µ¿¹ÝµÇ´Â ILD? scar cancer = scleroderma, ankylosing spondylitis, IPF

primary or metastatic ca = PM/DM

6. pneumothorax°¡ Àß »ý±â´Â ILD

neurofibromatosis, tuberous sclerois, histiocytosis-X, lymphangioleiomyomatosis

7. idiopathic eosinophilic pneumonia

i) Loeffler's syndrome

ii) acute eosinophilic pneumonia

iii) chronic eosinophilic pneumonia

iv) Churg-Strauss disease

v) idiopathic hypereosinophilic syndrome

8. ILDÀÇ PFT

1) obstructive pattern & TLC¡è

neurofibromatosis, tuberous sclerosis, histiocytosis X, LAM, sarcoidosis

cf. hypersensitivity pneumonitis: obstructive patternÀ» º¸Àϼö ÀÖ´Ù.

2) mixed restrictive and obstructive pattern: BOOP

9. normal BAL

alveolar macrophage 80%, lymphocyte 10%(ÀÌÁß 70%°¡ T-cell)

B cell or plasma cell 1-5%, neutrophil 1-3%, eosinophil 1%

CD4/8 = 1.5

10. BAL¿¡¼­ neutrophil Áõ°¡: "»õ·Î¿î CIA"

C: collagen vascular disease¿Í °ü·ÃÇÑ ILD

I : IPF, A: asbestos

11. BAL¿¡¼­ lymphocyte Áõ°¡: "¾à¿¡ °ú¹ÎÇÑ ILD´Â lymphocyte°¡ Áõ°¡ÇÑ´Ù°í SBS°¡

º¸µµÇß´Ù"

¾à: drug-induced ILD, °ú¹Î: hypersensitivity pneumonitis,

S: sarcoidosis, B: berylliosis

12. BAL»ó CD4/CD8¡è: " ½Ã¹ß(SBAR), Crohn's disease°¡ CD4°¡ Áõ°¡µÈ´Ü ¸»À̰¡!"

S: sarcoidosis, B: berylliosis, A: asbestosis, R: rheumatoid arthritis

13. BAL»ó CD4/CD8¡é: BOOP

"silicosisó·³ ¾à¿¡ °ú¹ÎÇÑ ILD´Â AIDSó·³ CD4°¡ °¨¼ÒÇÑ´Ù"

¾à¹°: drug-induced ILD, °ú¹Î¹ÝÀÀ: hypersensitivity pneumonitis

14. histiocytosis X´Â ´ëºÎºÐ Èí¿¬·ÂÀÌ ÀÖ´Ù.

15. diffuse panbronchiolitis¿Í °ü·ÃÇÑ HLA: HLA Bw54

16. DPBÀÇ sputum culture

Ãʱâ: H. influenza, S. pneumoniae

ÁøÇà: P. aeruginosa

17. DPBÀÇ PFT: °æµµÀÇ Á¦ÇѼºÀå¾Ö, ½ÉÇÑ Æó¼â¼º Àå¾Ö

18. DPBÀÇ Ä¡·á·Î macrolide¸¦ ¾²´Â ÀÌÀ¯? IL-8 levelÀ» °¨¼Ò½ÃÅ´(anti-inflammatory effect)

19. diffuse alveolar hemorrhage syndromeÀ» ¾ß±âÇÏ´Â Áúȯ

i) Goodpasture's syndrome

ii) IPF

iii) SLE

iv) Wegener's granulomatosis

20. pulmonary vasculitis¿Í °ü·ÃµÈ ILD

Wegener's granulomatosis, Churg-Strauss disease, hypersensitivity vasculitis

Necrotizing sarcoid granulomatosis

21. Wegener's granulomatosisÀÇ DOC? cyclophosphamide