Clinical features and Management of Restrictive Lung Diseases Flashcards
What is the physiological definition of restriction?
Forced vital capacity of less than 80% of predicted normal
Look
What is the marker of restrictino?
Vital capacity - spirometry
What are the lung causes of Interstitial lung diseases?
What are the possible routes of restriction?
What are the pleural causes of restrictive lung disease?
Pleural effusion
Pneumothorax
Pleural thickening - asbestos related, pneumonia
What are the skeletal causes of restrictive lung diseases?
Kyphoscoliosis
Ankylosing spondylitis
Thoracoplasty
Rib fractures - soreness
What are the muscular casues of restrictive lung disease?
Amyotrophic lateral sclerosis
Obesity - sub diaphragmatic - diaphragm can’t fall properly
Pregnancy - sub diaphragmatic
What is the interstitium?
What is sarcoidosis?
Multisystem granulomatous disease of unknown cause
What is the Histological hallmark of Sarcoidosis?
non-caseating granuloma
What are the clinical signs of sarcoidosis?
Erythema nodosum - granulomas often locate to scar tissue
Who gets sarcoidosis?
How do you investigate sarcoidosis?
History and exam
CXR
Bronchoscopy including transbronchial biopsies and endobronchial ultrasound
Pulmonary function tests
Bloods / urinalysis / ECG / TB skin test / eye exam
Surgical Biopsies (Mediastinoscopy, Video assisted thoracoscopic lung biopsy (VATS))
Look at chest x - rays
.
Look at the different stages as presented on these chest X-Rays
When would you provide no treatment for Sarcoidosis?
Mild disease, no vital organ involvement, normal lung function, few symptoms
When would you treat sarcoidosis with NSAIDS?
Erythema nodosum / arthralgia
When would you treat sarcoidosis with Topical steroids?
Skin lesions / anterior uveitis / cough
When would you treat sarcoidosis with Systemic Steroids?
Cardiac, neurological, eye disease not responding to topical Rx, hypercalcaemia
What is prognosis?
Few Caucasian’s die (<1%)
10-20% sustain permanent pulmonary or extra-pulmonary complications
Respiratory
»Progressive respiratory failure
»Bronchiectasis
»Aspergilloma, haemoptysis, pneumothorax
What is the typical presentation for idiopathic pulmonary fibrosis?
How does fibrotic tissue vary in the lung?
Usually most prominent in peripheral tissue, central tissue is usually unaffected - worsens as severity of the condition increases
What are the options for Idiopathic pulmonary fibrosis?
What initiates hypersensitivity pneumonitis?
Allergens from things like, pigeons, mould, farms etc
