Pulmonary - Restrictive Disorders

Question 1

How common is restrive lung disease?

Answer 1

Accounts for smaller % of patients than obstructive lung disease

Question 2

What is the cause of restrictive lung disease?

Answer 2

Intrinsic impairments or extrinsic conditions that affect:
- chest wall mobility
- neuromuscular function
- obesity

Question 3

What is the primary impaired function?

Answer 3

reduced lung expansion and lung volumes = hard time getting air into the lungs

Question 4

What is restrictive disorders?

Answer 4

fibrous deposits caused by interstitial restrictive lung disease which is due to inflammation process

Contributes to fibrosis and lung stiffness

Question 5

What is the normal work of breathing?

Answer 5

takes 5% of total VO2 max

Question 6

What is the work of breathing for RLD?

Answer 6

take as much as 40% of VO2 max

Question 7

Respiratory volume and capacity chart

Answer 7

Question 8

Restrictive vs normal

Tidal volume chart

Answer 8

Question 9

Restrictive vs obstructive vs normal

Changes in lung volume and capacities

Answer 9

Question 10

How is lung volume affected?

Answer 10

Decreased

Question 11

How is lung compliance affected?

Answer 11

Reduced
- normal elasticity but hard to get air in

Question 12

How is work of breathing affected?

Answer 12

Increased
- this can lead increased HR = higher resting HR

Question 13

What is FVC?

FVC = forced vital capacity

Answer 13

how much air that can be exhaled very fast and hard after full breath

Question 14

What is FEV1?

FEV = forced expiration volume

Answer 14

amount of air that can be exhaled forcibly in 1 sec after max breath

Question 15

How does FEV1 indicate COPD?

Answer 15

Greater reduction in forced expiration amount in 1 sec cuz of air tapping = lowering the ratio

Question 16

What FEV1/FVC ratio is indicated for restrictive lung disease?

Answer 16

A normal ratio or increased with decreased FVC

75-80% or higher

Volumes are reduced with less air in and out

Question 17

What FEV1/FVC ratio is indicated with mixed lung disease?

Answer 17

A low ratio with low TLC

Question 18

What is the FEV1/FVC ratio for obstructive disease?

Answer 18

ratio affected because of the trapped air
FEV1 and FVC reduced

< 70-80%

Question 19

What are the classic signs for RLD?

Answer 19

tachypnea
hypoxemia
fatigue
weight loss
decreased lung volumes
chronic dry cough
pulmonary HTN
can see: clubbing, cyanosis, decreased chest wall expansion

Question 20

What are the hallmark sx of RLD?

Answer 20

• Dyspnea
• Cough
• potenially wasted and emaciated appearance

Question 21

What are the effects of scarred interstitium?

Answer 21

Question 22

What are the 3 types of interstitial lung disease?

Answer 22

Exposure related
Autoimmune related
Idiopathic

Question 23

What are some of the exposure related causes of interstitial lung disease?

Can be drug induced or occupational/environmental causes

Answer 23

Question 24

What are some of the autoimmune related causes of interstitial lung disease?

Answer 24

Question 25

What are some of the idiopathic causes of interstitial lung disease?

Answer 25

Question 26

What is the cause of idiopathic pulmonary fibrosis?

Answer 26

Inflammatory process of alveolar wall = “scarring” -> fibrotic

Progressive disease

Question 27

How common is idiopathic pulmonary fibrosis?

Answer 27

Most common of the over 200 different fibrosis lung diseases

falling into larger group of interstitial lung diseaes

Question 28

What are the risk factors of idiopathic pulmonary fibrosis?

Answer 28

age
smoking
genetic predisposition
air pollution
viral infections
GERD

Question 29

What is the prevalence and clinical presentation of idiopathic pulmonary fibrosis?

Answer 29

• affects 1 out of 200 adults over age of 70
• typically between 50-70 y/o
• common in men
• sx of (constant dry cough, weight loss, fatigue, clubbing and edema)

Question 30

What is indicated to be irreversible damage for idiopathic pulmonary fibrosis?

Answer 30

• Enlarged airways and deformed alevoli
• honeycombing clustered appearance in air spaces
• decreased gas exchange = O2 transferred into blood