Clinical features of restrictive lung disease Flashcards
What is the 5 places that causes of restrictive lung diseases
Intersisitnal lung disease Pleural diseases Muscular and nerves Bones Sub diaphramatic
What is the definition of restriction
forced vital capacity <80% of the predicted normal
What is three examples of pleural diseases that result in restricting of the lung
Pleural thickening
Pleural effusion
pneumothorax
What is the possible aetiologies of pleural thickening
Long term inhalation of asbestos
What is examples of bone conditions causing restriction
Ankylosing spondylitis
Kyphoscoliosis
Thoracoplasty
Rib fractures
What is Ankylosing spondylitis
a type of arthritis in which there is long term inflammation of the joints of the spine
What was the cause behind Thoracoplasty
an operation to collapse down aerobic cavity to allow body immune system to fight of TB
What is examples of sub diaphragmatic lung restrictions
Pregnancy
Obesity
What is an example of a nerves muscle conditions that reduces lungs compliance and how
Amyotrophic lateral sclerosis
muscle pump driving the lungs isn’t working
When lungs causes restrictiveness its due to intestinal lung disease, what is the pathology of this?
thickening of interstitium
What is 3 examples of intestinal lung disease
sarcoidosis
hypersensitivity pneumonitis
Interstitial pneumonitis
response
How can you define sarcoidosis from TB
non caseating granuloma
Where do the granulomas in sarcoidosis usually migrate to
scar tissue
Where is sarcoidosis most likely to affect
the lymph, lungs and skin
- less likely eyes
What is the investigations for sarcoidosis
Chest X ray Pulmonary function test blood test eye exam TB test Bronchoscopy ECG CT scan calcium serum levels
What can be seen at the different stages of a chest x ray in sarcoidosis
Stage 0 is a normal chest radiograph
Stage I is lymphadenopathy only
Stage II is lymphadenopathy and lung parenchymal disease
Stage III is parenchymal lung disease only
Stage IV is pulmonary fibrosis
What can be seen on a bronchoscopy for a patient with sarcoidosis
see white patches with a cobble stone appearance
What surgery is useful in diagnosing sarcoidosis and why
mediastinoscopy - pull out a lymph node with granulomas
video assisted thorascopic lung biopsy
What is prescribed for the symptoms of Erythema nodosum and arthralgia
(skin inflammation and pain in the joints)
NSAIDS
When no vital organs are involved in sarcoidosis what is the treatment
No treatment, just keep a careful observation
When would topical steroid be prescribed in the case of sarcoidosis
when you have the symptoms of skin lesions, cough
When would systemic steroids be prescribed in the case of sarcoidosis
Cardiac, neurological, eye disease not responding to topical steroids
or hypercalcaemia
What are example of the 10-20% possible chance of pulmonary complications sarcoidosis
Progressive respiratory failure
Bronchiectasis
Aspergilloma, haemoptysis, pneumothorax
What is idiopathic pulmonary fibrosis
progressive decline in lung function due to scarring of lung tissue - worsening dyspnea
What investigations are used for pulmonary fibrosis
Chest x ray
CT
What is the appearance of pulmonary fibrosis on a chest Xray
Fuzzy appearance
smaller lung volume
What is the appearance of pulmonary fibrosis on a CT scan
Cloudy and white stuff around the edges
What is the treatment options for pulmonary fibrosis
Palliative care - for the old and frail
Prescribe oral anti fibrotic
Surgery - transplant (must meet certain criteria)
What are the two oral anti fibrotic and what is there function
Pirfenidone and Nintedanib
Dont cure, but half the rate of progression
