Internal Medicine

0521779407-10 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 18:40

Insomnia Interstitial Lung Diseases 841

➣Maintain regular sleep/wake schedule; avoid naps

➣Avoid caffeine, alcohol, heavy meals before sleep

➣Stop or replace potentially offending meds

➣Sleeping area should be cool, quiet, dark

specific therapy

■Depends on cause

■Pts w/ sleep apnea benefit from continuous positive airway pressure

■See treatment of restless leg syndrome for periodic limb movements

in sleep

follow-up

■Depends on cause

complications and prognosis

■Depend on cause

Interstitial Lung Diseases..............................

JEFFREY A. GOLDEN, MD

history & physical

History

■Dyspnea and diffusely abnormal radiograph in context of chronic

process exclusive of infection & malignancy

■Shortness of breath with exertion; progressing to dyspnea at rest

■Nonproductive cough, esp with a deep breath

■Etiologic exposure &/or associated systemic diseases:

➣work/environment (asbestos; organic materials/dusts, moldy

wood, birds)

➣Medication with lung toxicity

➣Rheumatologic symptoms and signs

■Associated systemic illness: rheumatologic disease

Signs & Symptoms

■Rapid shallow breathing

■Inspiratory dry (“Velcro”) crackles

tests

Laboratory

■ESR, ANA, rheumatoid factor, other serologies