Pulmonary Pathophysiology- Restrictive Lung Disease Flashcards
What is the general characteristic of restrictive lung disease?
can’t get air in mainly due to decreased chest and lung compliance
In RLD what must increase as a response to decreasing Vt?
RR, which causes increase in metabolic demand to breath
What happens if you begin to lose your lung compliance?
more inspiratory muscle are needed to pull the lungs open
What is the general theme with the LFT value’s?
All values will decrease but ratios will stay the same because all values are decreasing
Vt very last value to decrease
Which LFT is much more decreased in restrictive than obstructive?
DLCO
What is interstitial pulmonary fibrosis?
an overwhelming inflammatory process involving all parts of the alveolar wall
life expectancy after diagnosis is less than 6 years
What is pathogenesis of IPF?
likely an inflammatory trigger
ex. cigarette smoke, viral/bacteria infection
What is pathophysiology of IPF?
initial changes due to inflammation but then this destroys lung parechyma allowing fibrin to enter alveoli and leads to scarring
this clogs alveoli making it harder to pull lungs open
What happens due to thickening of alveolar walls?
leads to less gas exchange, decreased elasticity and lung compliance and increases work of breathing
Why does DLCO drop on IPF?
increased distance to get to alveoli, increased alveoli size, loss of capillaries, fibrin interferes with gas exchange
What will you see on chest x ray in pts with IPF?
reticulonodular patterns (lines with nodes)
What are main clinical signs of IPF?
- breath sounds- diminished with fine crackles (sounds like velcro)
- Dyspnea- initially on exertion but progresses to rest- progression is key sign
- weight loss- due to increased work of breathing
What are other potential clinical signs of IPF?
cough- dry and non mucus clearing
hypoxia- decreased SpO2, cyanosis, constriction of vessels
Tx of IPF?
drugs, oxygen, nutrition, lung transplant
Will aerobic conditioning help patients with IPF?
No, b/c it changes muscle ability to efficiently use O2 therefore you need lessO2 to perform
however in IPF you are not getting a lot of air into to begin with an aerobic conditioning can’t help that
What is sarcoidosis?
mutlisystem disease caused by granulomas in different organs- most common in lungs
these granulomas infiltrate alveolar walls and cause fibrosis and inflammatory response
What are other characteristics of sarcoidosis?
fatal in only 5-10% of pts, uncommonly seen and 25% of pts wont seen lung function drop
treat like IPF
What is broncholitis?
fibrotic lung disease that affects small airways due to necrosis of respiratory epithelium causing inflammatory response similar to IPF
uncommon but seen in pts under 2 and after lung transplants
tx: similar to IPF
What are three groups of occupational lung disease?
- toxic fumes-
- mineral dusts- silica, coal dust, asbestos
- organic dusts- mostly farm or animal related
What are signs of OLD?
chronic cough, weight loss, DOE, declining PFT
tx: similar to IPF mostly supportive, try and remove trigger
Why is obesity a RLD?
subcutaneous fat decreases chest wall compliance and increases work of breathing
What is scleroderma?
progrssive systemic connective tissue disease
if in lungs presents as IPF
What is atelectasis?
loss of volume of lung tissue due to lack of expansion of structures in respiratory zone, basically collapsing of alveoli
Can you find atelectasis in healthy patients?
Yes this is why we yawn and take deeper breaths unconsciously at times
