Pathology of Restrictive Lung Disease Flashcards

1
Q

restrictive also known as

A

interstitial

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2
Q

interstitium of the lung is the

A

connective tissue space around the airways and vessels and the space between the basement membranes of the alveolar walls

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3
Q

restrictive lung disease has a …… FEV1 and a ……. FV and a therefore a …….. FEV1/FVC ratio

A

low FEV1

low FVC

normal FEV1/FVC ratio

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4
Q

Characteristic of restrictive lung disease

A

reduced gas transfer (diffusion abnormality)

Ventilation/perfusion imbalance

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5
Q

Diffuse lung disease presentation

A

discovery of abnormal CXR

Dyspnoea

Respiratory failure (type 1)

heart failure

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6
Q

DAD

A

Diffuse alveolar damage

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7
Q

Diffuse alveolar damage

A

histological pattern in lung disease

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8
Q

DAD is associated with…

A

major trauma

chemical injury/ toxic inhalation

circulator shock

drugs

infection

(but can sometimes be idiopathic)

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9
Q

Histological features of DADs

A

Protein rich oedema

fibrin

hyaline membranes

denuded basement membranes

epithelial proliferation

fibroblast proliferation

scarring (interstitial and airspaces)

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10
Q

Sarcoidosis

A

A multisystem granulomatous disorder of unknown aetiology

commonly effects young adults (F>M)

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11
Q

Sarcoidosis presnetation

A

Young adult

incidental abnormal CXR (but no symptoms)

SOB, cough, abnormal CXR

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12
Q

If persistent (after 2 or 3 years) sarcoidosis is treated with

A

corticosteroids

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13
Q

Sarcoidosis investigation

A

imaging

serum calcium and ACE

biopsy

pulmonary function tests

blood/urine/ECG eye exam

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14
Q

Hypersensitivity pneumonitis definition

A

an inflammation of the alveoli within the lung caused by hypersensitivity to inhaled organic dusts

also known as extrinsic allergic alveolitis

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15
Q

Hypersensitivity pneumonitis (the antigens)

A

thermophilic actinomycetes

brid/animal proteins

fungi

chemicals

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16
Q

Hypersensitivity pneumonittis

Acute presentation

A

fever, cough, malaise

chills (4-9 hours)

crackles, tachyopnoea, wheeze

17
Q

Hypersensitivity presentation

A

malaise, SOB, Cough

low grade illness

crackles some wheeze

can lead to respiratory failure (low gas transfer also)

18
Q

Histopathology of hypersensitivity pneumonitis

A

immune complex mediates combined type III and type IV hypersensitivity reaction

19
Q

Usual interstitial pneumonitis (UIP)

A

is a form of lung disease characterized by progressive scarring of both lungs

20
Q

UIP can be seen in

A

connective tissues diseases

drug reactions

post infection

industrial exposure (asbestos)

(progressive disease -most dead in about 5 years)

21
Q

Histopathology of UIP

A

patchy, interstitial chronic inflammation

type II pneumocyte hyperplasia

smooth muscle and vascular proliferation

22
Q

UIP clinical symptoms

A

dyspnoea

cough

basal crackles

cyanosis

clubbing

23
Q

UIP

A

basal and posterior fibrosis with honeycombing

24
Q

Type I respiratory failure is PaO2 less than

25
Type II respiratory failure is PaCO2 greater than
6.5 kPa
26
Hypoxaemia
alveolar hypoventilation shunt V/Q imbalance diffusion impairment
27
Fall in PaO2 due to HYPOventilation is corrected by raising
FIO2 (fraction of inspired air which is oxygen)
28
Shunt
blood passing from right to left side of heart WITHOUT contacting ventilated alveoli
29
3 main types of interstitial lung disease are
idiopathic pulmonary fibrosis sarcoidosis hypersensitivity pneumoitis
30
Pleural causes of interstitial lung disease
pleural effusion pneumothorax pleural thickening
31
Muscles causes of interstitial lung disease
Amyotrophic lateral sclerosis
32
sub-diaphragmatic causes of interstitial lung disease
obesity pregnancy
33
skeletal causes of interstitial lung disease
Kyphscoliosis Rib fractures Thoracoplasty
34
Sarcoidosis histological hallmark
non-caveating granuloma
35
Sarcoidosis further investigation
bronchoscopy | including biopsies and ultrasound