pathology of restrictive lung disease Flashcards
what is the interstitium of the lung
the conective tissue soace around the airways and vessels and the soace between the basement membtanes of alveolar walls
what are the featires of restrictive diffuse interstitial lung disease
reduced lung compliance - stiff lungs
low FEV1 and low FVC but FEV1/FVC normal ratio
reduced gas transfer (Tco or Kco)
- diffusion abnormality
ventilation/perfusion imbalance
- when small airways affected by pathology
how does diffuse lung disease present
discovery of abnormal CXR or CT
dyspnoea
- shortness of breath on exertion
- shortness of breath at ready
resp failure - type 1
heart failure
what are chronic responses as a resukt to parenchymal (interstitial) lung injury
usual intersitial pneumonitus (UIP)
granulomatous responses
other patterns
what is an example of an acute response
diffuse alveolar damage (DAD)
what is DAD associated with
makor truama chemical injury/toxic inhalatjon circulatory shock drugs infection including viruses auto(immune) disease radiation
what are histological features of DAD
protein rich oedema fibrin hyaline membranes denudes basement membranes epithelial proliferation fribroblast proliferation scarring - interstitium and airspaces
what are examplea of acite granulomatous response
sarcoidosis
hypersensitivity pneumonitis
what is sarcoidosis
a multisystem granulomatous disorder of unknown aetiology
what is the histopathology of sarcoidosis
epitheliod and giant cell granulomatous necrosis/ caseation very unusual little lymphoid infiltrate variable associated fibrosis type 4 hypersensitivity
what organs are involved in sarcoidosis
lymph nodes lung spleen liver skin, eyes, skeletal muscle bone marrow salivary glands
how does sarcoidosis present
acute arthralgia erythema nodosum bikateral hikar lymphadenopathy incidental abnormal CXR or CT SOC, cough and abnormal CXR
how do you disgnose sarcoidosis
clinical findings imaging serum calcium and ACE biopsy kveim test tuberculin test
what is hypersensitivity pneumonitis
reaction to organic molecules or antigens thermophilic actinomycetes - farmers lung - micropolyspora faeni - thermoactinomyces vulgaris bird animal proteins - faces and bloom fingu - asoergillus spp chemicals others
what is the acute oresentation of hypersensitivity pneumonitis
fever drt cough myalgia chills 4-9 hds aftr ag exposure crackles, tacgypnoea, wheeze precipitating antibody
