What are signs & symptoms of Pulmonary Fibrosis? - Dr. Hirennappa B Udnur

We are just going to talk about classically classical presentation of idiopathic pulmonary fibrosis. Any patients who is aged and who is a smoker or who comes with a dry irritating cough without much of reduction for more than 3 months duration and breathlessness on exertion which is not explained by any cardiac or any airway disease like asthma or COPD. Here we should suspect pulmonary fibrosis, and sometimes extension of vital signs is pulse oximeter or oxygenation. That is the one things that is it important in diagnosing pulmonary fibrosis early where we see the vital signs, check the saturation, which is borderline and when they do a 6 minute walk tests or on exercise, the oxygen will drop. If there is a significant drop, then it means that there will be a diffusion limitation in the lung, which is normally happens in any interstitial pathology. We can have any diffusion limitation in the lung, which normally happens in any interstitial pathology. We can have diffusion limitation in any interstitial pneumonia also. But overall when you are diagnosing this is the important rule in checking the saturation. The third things and signs are usually we get clubbing. Clubbing has a positive predictive value over idiopathic pulmonary fibrosis, which is 90%. Usually we term it as idiopathic pulmonary fibrosis, which says that it is long duration disease and on auscultation the most important finding is bilateral basal crepitations what we see on a stethoscope as the most important in diagnosing this apart from this if you don’t hear any additional sounds like wheeze or other things. If you hear crepitation, which we see in basal region like in pulmonary edema, which is the most common cause of crepitation there in a dependent region. But on bending forward also, even if they do upside down the patients, and you get persistent cramps because the fluid of pulmonary edema, we are dependent, because on bending forward, the crackles decrease. Here it increases and they are more of an inspiratory type of crepitations, these are the most important clinical signs. If you are suspecting other than idiopathic pulmonary fibrosis, we get clues in diagnosis. Clues in diagnosis are bronchiolitis obliterans with organizing pneumonia, they have persistent fever inspite of antibiotics, we have the clue for it and there are other pneumonic features for it. Sometimes skin rashes, a particular type of skin rashes and telengectasia, which can be a clue for any kind of connective tissue disorder. Bilateral pitting edema are the features of cor pulmonale and cyanosis. These are the features of pulmonary edema. Based on the types, certain risk factors for LIP and other things like smoking and smoking stains are seen in the oral cavity and there might be clues for any connective tissue disorder anywhere in the body. That is when we suspect that this might be a disease of interstitial pathology where the loose term of pulmonary fibrosis has been used for a general public. In a pulmonology circle pulmonary fibrosis actually means it is idiopathic pulmonary fibrosis, which is the gravest of all kinds of pulmonary fibrosis.