Clinical Features and Management of Restrictive Lung Disease

Question 1

What is the physiological definition of restriction?

Answer 1

Forced vital capacity less than 80% of the predicted normal

Question 2

What are the interstitial lung diseases that cause restriction?

Answer 2

Idiopathic pulmonary fibrosis
Sarcoidosis
Hypersensitivity pneumonitis

Question 3

What are the pleural causes of restriction?

Answer 3

Pleural effusion
Pneumothorax
Pleural thickening

Question 4

What are the skeletal causes of restriction?

Answer 4

Kyphoscoliosis
Ankylosing spondylitis
Thoracoplasty
Rib fractures

Question 5

What are the muscular causes of restriction?

Answer 5

Amyotrophic lateral sclerosis

Question 6

What is sarcoidosis?

Answer 6

Multisystem granulomatous disease of unknown cause

Question 7

What is the histological hallmark of sarcoidosis?

Answer 7

Non-Caseating granuloma

Question 8

What are the sub-diaphragmatic causes of restriction?

Answer 8

Obesity

Pregnancy

Question 9

How is sarcoidosis investigated?

Answer 9

History and exam 
Chest radiograph 
Pulmonary function tests 
Bloods 
Urinalysis 
ECG 
TB skin test 
Eye exam 
Mediastinoscopy 
VATS

Question 10

What is mild sarcoidosis?

Answer 10

No vital organ involvement
Normal lung function
Few symptoms

Question 11

What is the treatment of mild sarcoidosis?

Answer 11

No treatment

Question 12

What is the treatment of sarcoidosis with skin lesions, anterior uveitis and cough?

Answer 12

Topical steroids

Question 13

When are NSAIDs used to treat sarcoidosis?

Answer 13

When there is erythema nodosum or arthralgia

Question 14

When should systemic steroids be used to treat sarcoidosis?

Answer 14

When there is cardiac, neurological or eye disease that is not responding to topical medicine or with hypercalcaemia

Question 15

What is idiopathic pulmonary fibrosis?

Answer 15

Scarring of the lung tissue that causes a decrease in lung function with an unknown cause

Question 16

What is a typical presentation of idiopathic pulmonary fibrosis?

Answer 16

Chronic breathlessness and cough 
Typically 60-70 years old
More likely a man 
Failed treatment for infection or LVF
Clubbing 
Crackles at the end of inspiration