Clinical Features and Management of Restrictive Lung Disease Flashcards
What is the physiological definition of restrictive lung disease?
FVC < 80% of best
What are lung causes of restrictive lung disease?
Sarcoidosis
Idiopathic pulmonary fibrosis
Hypersensitivity pneumonitis
What are pleural causes of restrictive lung disease?
Pleural effusions
Pneumothorax
Pleural thickening
How can a pleural effusion be a restrictive lung disease?
The fluid on the outside of the lung can compress the lung
How can a pneumothorax be a restrictive lung disease?
The air in the pleural space can compress the lung or just cause it to collapse
What is the most common cause of pleural thickening?
Asbestos
What are some skeletal causes of restrictive lung disease?
Kyphoscoliosis
Ankylosing spondylitis
Thoracoplasty
Rib fractures
How can kyphoscoliosis cause restrictive lung disease?
It decreases chest expansion
How can ankylosing spondylitis cause restrictive lung disease?
It decreases chest expansion
How can thoracoplasty be a restrictive?
It prevents one lung from inflating
What is a muscle cause of restrictive lung disease?
Amyotrophic lateral sclerosis
What are some sub-diaphragmatic of restrictive lung disease?
Obesity
Pregnancy
Where is the interstitium?
Between the epithelium of the alveolus and endothelium of the capillary
What is sarcoidosis?
Multisystem granulomatous disease of unknown cause
Contains non-caveating granuloma
What are the investigation for sarcoidosis?
CXR PFT FBC U+Es urinalysis ECG TB skin test Eye exam
Bronchoscopy: trans bronchial biopsies and endobronchial ultrasound
Mediastinoscopy
How is sarcoidosis treated if it is mild, no vital organ involvement, normal lung function and few symptoms?
No treatment
Can sarcoidosis resolve itself?
Yes
What is the treatment of sarcoidosis with erythema nodosum?
NSAIDs
What is the treatment of sarcoidosis, anterior uveitis, cough and skin lesions?
Topical steroids
What is the treatment for cardiac, neurological, eye disease (not responding to topical steroids) and hypercalcaemia?
Systemic steroids
What are complications of sarcoidosis?
Progressive respiratory failure
Bronchiectasis
Aspergilloma, haemoptysis, pneumothorax
What does idiopathic pulmonary fibrosis typically present with?
Chronic SOB and cough Older men No response to treatment for LVF or infection Clubbing Crackles
What is the management for idiopathic pulmonary fibrosis?
Refer to Interstitial lung disease clinic
Oral anti-fibrotic - pirfenidone, nintedanib
Palliative care
Transplant
