Pathology of Restrictive Lung Disease

Question 1

Effects

Answer 1

Reduced lung compliance
Low FEV1 and FVC but normal ratio
Reduced gas transfer

Question 2

Presentation

Answer 2

Dyspnoea (at rest/on exertion)
Type 1 respiratory failure
Heart failure
CXR less space in chest where lungs are than normal

Question 3

Parenchyma

Answer 3

The portion of the lung involved with gas exchange - alveoli, respiratory bronchioles and alveolar ducts

Question 4

Diffuse interstitial lung disease leads to

Answer 4

Parenchymal lung injury to ACUTE RESPONSE to CHRONIC

Question 5

Chronic response to

Answer 5

Usual interstitial pneumonitis (UIP)
Granulomatous responses
Other patterns

Question 6

Sarcoidosis

Answer 6

Multisystem granulomatous disorder of unknown aetiology, commonly affects young adults

Question 7

Presentation of sarcoidosis

Answer 7

Incidental abnormal CXR with no symptoms

Abnormal CXR, SOB and cough

Question 8

Hypersensitivity pneumonitis antigens

Answer 8

Inhaled =>
Bird / Animal proteins - faeces, bloom
Fungi  - Aspergillus spp
Chemicals
Others

Question 9

Acute presentation HP

Answer 9

Fever, dry cough, myalgia,
Chills 4-9 hours after Ag exposure
Crackles, tachyopnoea, wheeze
Precipitating antibody

Question 10

Chronic presentation HP

Answer 10

Insidious
Malaise, SOB, cough
Low grade illness	
Crackles and some wheeze
Gas transfer low - can lead to respiratory failure

Question 11

Immune complex mediated types

Answer 11

III & IV

Question 12

Histopathology of UIP

Answer 12

Patchy interstitial chronic inflammation
Type II pneumocyte hyperplasia
Smooth muscle and vascular proliferation