- Pathology of Restrictive Lung Disease Flashcards
<p>What is the interstitium of the lung?</p>
<p>Connective tissue space around the airways and vessels and the space between the basement membranes of the alveolar walls</p>
<p>What is the connective tissue space around the airways and vessels called?</p>
<p>Interstitium of the lung</p>
<p>How are alveolar epithelial (pneumocytes) and interstitial capillary endothelial cell basement membranes in normal alveolar walls?</p>
<p>In direct contact</p>
<p>What does restrictive lung disease show?</p>
<p>Reduced lung compliance (stiff lungs)</p>
<p>Low FEV1and low FVC but same FEV1/FVC ratio</p>
<p>Reduced gas transfer</p>
<p>Ventilation/perfusion mismatch</p>
What does the spirometry of restrictive lung disease look like ?
<p>What is the presentation of restrictive lung disease?</p>
<p>Abnormal chest X-ray</p>
<p>Dyspnoea (on exertion and rest))</p>
<p>Respiratory failure (type 1)</p>
<p>Heart failure</p>
<p>What is dyspnoea?</p>
<p>Difficult breathing</p>
<p>What is difficult breathing called?</p>
<p>Dyspnoea</p>
<p>What is the difference in chest X-rays between:</p>
<p>Emphysema<br></br>Normal<br></br>Restrictive lung disease</p>
<p>Emphysema can see all ribs</p>
<p>Normal can see 10 ribs</p>
<p>Restrictive lung disease can see less than 10</p>
<p>What is restrictive lung disease also known as?</p>
<p>Interstitial lung disease</p>
<p>What is the pathway leading to restrictive lung disease?</p>
<p>1) Lung injury</p>
<p>2) Leads to chronic response</p>
<p>3) One of usual interstitial pneumonitis (UIP), granulomatous response, or other pattens leads to</p>
<p>4) Fibrosis or end stage honeycomb lung</p>
<p>What does the acute response to lung injury lead to?</p>
<p>Diffuse alveolar damage</p>
<p>What is diffuse alveolar damage associated with?</p>
<p>Major trauma</p>
<p>Chemical injury/toxic inhalation</p>
<p>Circulatory shock</p>
<p>Drugs</p>
<p>Infection</p>
<p>Autoimmune disease</p>
<p>Radiation</p>
<p>Idiopathic</p>
<p>What does idiopathic mean?</p>
<p>No known cause</p>
<p>What is no known cause called?</p>
<p>Idiopathic</p>
<p>What does the extend of diffuse alveolar damage depend on?</p>
<p>How many days the injury lasts for</p>
<p>What does DADS stand up for?</p>
<p>Diffuse alveolar damage</p>
<p>What are the histological features of acute alveolar damage?</p>
<p>Protein rich oedema</p>
<p>Fibrin</p>
<p>Hyaline membranes</p>
<p>Denuded basement membranes</p>
<p>Epithelial proliferation</p>
<p>Fibroblast proliferation</p>
<p>Scarring</p>
<p>Why do granulomatous responses to chronic inflammation lead to fibrosis or end stage honeycomb lung?</p>
<p>Sarcoidosis</p>
<p>Hypersensitivity pneumonitis</p>
<p>What is sarcoidosis?</p>
<p>Multisystem granulomatous disorder of unknown aetiology</p>
<p>What is a multisystem granulomatous disorder of known aetiology?</p>
<p>Sarcoidosis</p>
<p>What is the histopathology of sarcoidosis?</p>
<p>Epitheloid and giant cell granulomas</p>
<p>Necrosis/caseation very unusual</p>
<p>Little lymphoid infiltrate</p>
<p>Variable associated fibrosis</p>
<p>What is a granulomas?</p>
<p>Structure formed during inflammation that is found in many diseases, being a collection of macrophages</p>
<p>What is a structure formed during inflammation that is composed of a collection of macrophages?</p>
<p>Granulomas</p>
<p>What is the purpose of a granulomas?</p>
<p>Wall of a substance that cannot be destroyed</p>
<p>What is used to wall of a substance that cannot be destroyed?</p>
<p>Granulomas</p>
<p>Who does sarcoidosis commonly affect?</p>
<p>Young adults</p>
<p>Does sarcoidosis affect more males or females?</p>
<p>Females</p>
<p>What is the prevalence of sarcoidosis?</p>
<p>3-4/100,000 in UK</p>
<p>Where is sarcoidosis often common?</p>
<p>Temperate climates</p>
<p>What organs are involved in sarcoidosis?</p>
<p>Lymph nodes</p>
<p>Lung</p>
<p>Spleen</p>
<p>Liver</p>
<p>Skin, eyes, skeletal muscle</p>
<p>Bone marrow</p>
<p>Salivary glands</p>
<p>What are the most common organs involved in sarcoidosis?</p>
<p>Lymph nodes (100% of cases)</p>
<p>Lung (90% of cases)</p>
<p>Spleen (75% of cases)</p>
<p>What are typical presentations of sarcoidosis?</p>
<p>Young adult (acute arthralgia, erythema nodosum, bilateral hilar lymphadenopathy)</p>
<p>Incidental abnormal chest X-ray (no symptoms)</p>
<p>Shortness of breath, cough, and abnormal X-ray</p>
<p>What is acute arthralgia?</p>
<p>Joint pain</p>
<p>What is joint pain called?</p>
<p>Acute arthralgia</p>
<p>What is erythema nodosum?</p>
<p>Swollen fat under the skin that causes red bumps</p>
<p>What is swollen fat under the skin that causes red bumps called?</p>
<p>Erthema nodosum</p>
<p>What is bilateral hilar lymphadenopathy?</p>
<p>Bilateral enlargement of the lymph nodes of pulmonary hila</p>
<p>What is bilateral enlargement of the lymph nodes of pulmonary hila called?</p>
<p>Bilateral hilar lymphadenopathy</p>
<p>How long does it take for most presentations of sarcoidosis to resolve?</p>
<p>2 years</p>
<p>What are the possible outcomes of sarcoidosis after 2 years?</p>
<p>Resolve</p>
<p>Persist</p>
<p>Progress</p>