11- Restrictive Lung Disease Flashcards
PFT test in RLD
Fev1/fec= same or increased
RLD has increased elasticity because of what ?
Fibrous tissue
What kind of cough in RLD
Dry cough
Type of fibrosis in restrict lung disease
Reticular
Modular
Retinulonodular
RLD of lung show what
Diffuse infiltrate -ground glass shadows
RLD what are the four pneumoconiosis
Asbestosis
Silicosis
Coal workers pneumoconiosis
Berylliosis
What are the three types of coal workers pneumoconicosis
Asymptomatic pulmonary anthracosis
Simple CWP
Complicated CWP
RLD from inorganic material leads to what disease
Pneumoconicosis
RLD that comes about from organic particles
Hypersensitivity pneumonitis
What lung Disease shows increase in diffuse linear markings in lung x ray
RLD
What is the mc pneumoconicosis and occupational lung disease in the world
Silicosis
What factors do macrophages release in RLD that lead to collagen deposition and fibrosis
Toxic factors
Pro inflammatory factors
Fibrogenic factors
Another name for coal dust
Anthracotic pigment
Microscopy of pulmonary Asymptomatic anthracosis has what?
Dust macrophage cells but no fibrosis
Simple CWP characteristics by what?
Nodular masses composed of collagen fibers and pigment
The other name for progressive massive fibrosis
Complicated CWP
Complicated CWP characterized by what ?
Fibrotic Opsacities >1cm on xray
Dense collagen
And Anthrocotic pigment
What is the complication of progressive massive fibrosis ?
Crippling lung disease , black lung disease
DD of black lung disease
Metastasis
What is coal workers lung
When Anthrocotic pigment turns fibrogenic
What and with what is caplan syndrome seen
Having one of the three disease plus RA nodules in arms and legs
Asbestos, silicosis , CWP
What is inhaled in silicosis
Crystalline silicone dioxide
Is anthracotic pigment fibrogenic
No
Is crystalline silicone dioxide fibrogenic
Yes
Complication of RLD
Fibrosis -hypoxemia- PH-COR pulmonale- RHF
Two forms of silicosis
Amorphous
Crystalline
With silicosis you have increased risk of acquiring what infection
TB
Chronic nodular silicosis results in what in lung
Nodular opacities with concentric layers of collagen fibers **(purple )
Who acquires silicosis
Miners
Sandblastee
Mining
How are silicosis particles seen?
Birefringent polarized light
Where nj the lung does silicosis mostly occur
Apex
What differentiates asbestos from silicosis depending on nodules ?
Asbestos doesn’t have large nodules
What fibers are carcogenic and what do they cause
Asbestos
Mc lesion associated with exposure to asbestos
Pleural plaques
Asbestos is a crystalline silicate with what subfamilies
Serpentine -chrysotile
Amphibole crocidolite
Mc form of cancer from asbestos
Broncogenic carcinoma
What are serpentine crystals where they go and what they cause -asbestos
Chrysotile asbestos crystals
Curly and flexible
Upper airway
Interstitial fibrosis and Broncogenic carcinoma
What are amphibole crystals and where and what do they cause -asbestos
Crocidolite
Straight -deep lung to pleura
Lung cancer -Broncogenic carcinoma and mesothelioma
What are asbestos fibers phagocytosed by macrophages and coated by iron called ?
Ferruginous bodies -dumbbell
What stain to see ferruginous bodies
Prussian blue stain
Asbestos bodies are coated with what by macrophages
Iron and calcium, and proteinaceous materials
What are benign pleural plaques composed of in asbestos
Fibrosis and calcification
Where are benign pleural Plaques found
On pleura and domes of diaphragm
Age benign pleural plaques a precursor for mesothelioma
No
Asbestos can lead to what
Benign pleural plaques
Diffuse interstitial fibrosis -bands if fibrosis
Lung cancer
What does berylliosis result in
Diffuse interstitial fibrosis with noncaseating ganulomas
RLD that lead to noncaseating granulomas
Berylliosis
Hypersensitivity pneumonitis
Sarcoidosis
Hypersensitivity pneumonitis is due to what
Bacwrialmorndingal vegetable matter or moldy droppings repeated exposure
The other name for hypersensitivity pneumonitis
Allergic alveolitis
Is esonophIia present in hypersensitivity pneumonitis
No
What type of hypersensitivity is hypersensitivity pneumonitis
Type 3 and 4
Acute hypersensitivity pneumonItis is how long ? And HS?
4-6 hrs
3
Chronic hypersensitivity pneumonItis is what kind of HS
IV with fibrosis and interstitial non caseasting granulomas
Most common targets of sarcoidosis
Lung
face
Salivary gland
Skin
What is the second most common RLD
Sarcoidosis
What is the mc noninfectious granulomatous disease of lung
Sarcoidosis
What is the antigen in sarcoidosis and what cell does it interact with to illicit what hypersensitivity reaction
Unknown antigen with cd4 helper cell- type IV reaction
Treatment for sarcoidosis
Steroids
X-ray sarcoidosis has what appearance ?
Reticulonodular potato pattern nodes -enlarged hilar lymph nodes
Diseases with granulomas?
Berylliosis Hypersensitivity pneumonitis-farmers lung Sarcoidosis TB Histoplasmosis
Why organ does sarcoidosis primarily target
Lungs
What does sarcoidosis granulomas contain ?
Multinucleated giant cells with
Laminated calcium concentrates- schaumann bodies
Stellate inclusions -asteroid bodies
Sarcoidosis is seen In what people ?
Seamstress
What does sarcoidosis cause I eyes
Uveitis blurry vision
What does sarcoidosis cause in skin ?
Painful Erythema nodosum- no Granuloma located in Ant.leg
Nodular painless lesions - with granuloma
What does sarcoidosis do to the liver
Granulomatous hepatomegaly
What is the name of the syndrome I. Sarcoidosis that involves lacrimal gland and parotid enlargement ?
Mikulicz syndrome
Sarcoidosis patient presentation in lab? P.e.?
Hypercalcemia
Increase ACE
Deceased ADH
Night sweats, cough -mc
Why does sarcoidosis have diabetes insidious
Hypothalamic and posterity pituitary disease so no ADH
What so the granulomas secret and what do they cause ?
Secrete 1alpha hydroxylase- Hypercalcemia (kidney,liver)
^ACE- hypertension
Sarcoidosis is a diagnosis of what?
Exclusion
Good pasture syndrome mostly occurs in what sex
Males
Good pasture characterized by
Glomerulinephritis
Hemorrhagic interstitial pneumonitis
Lung then kidney
Hemoptysis then glomerulonephritis
What antibody is Involved in Good pasture against what?
IgG against alveolar and glomerular capillaries BM
Presentation if good pastures ?
Hematuria and proteinuria {ab)
What happens when goodpastures turns chronic?
Focal necrosis and hemorrhagic
What kind of HS is GP?
2
What disease has alveolar interstitial fibrosis of unknown ***origin and leads to dilation of airways with honeycomb appearance ?
Idiopathic pulmonary fibrosis
Stretch alveoli no collapse
No diaphragm depression
Honey come appearance is seen in what?
Eventually all restrictive lung disease
How are tlc and rv in restrictive ins disease ?
Both decreased
Pneumoconicosis inorganic material that are big get. Impacted where ?
Bifurcation of alveolar ducts
Which RLD has an increase risk to TB
Silicosis
Coal miners lung
What organisms are farmer lung exposed to?
Thermophilic actinimyces
RLD with nodules
Simple CWP
Complex CWP
Silicosis
RLD with reticulonodules
Sarcoidosis
