restrictive 1 Flashcards
main feature of restrictive
reduced expansion leading to decreased TLC and decreased FVC
acute lung injury
abrupt onset of significant hypoxemia and diffuse pulmonary infiltrates in the absence of cardiac failure
2 types of acute lung injury
acute respiratory distress
respiratory distress syndrome of the newborn
acute respiratory distress
mostly seen in adults
respiratory distress of the newborn
low birth weigh, prematurity
acute lung injury mortality
40%
acute lung injury histologically
diffuse alveolar damage with hyaline membranes, hemorrhagic and heavy lungs, reactive proliferation of type 2 pneumocytes
chronic interstitial lung diseases
heterogenous group of disorders
inflammation and fibrosis of the pulmonary connective tissue, mainly interstitial between. the alveolar walls
common features of chronic interstitial lung diseases
reduced compliance - stiffening
reduced diffusion capacity
reduced lung volume
4 categories of interstitial lung diseases
- fibrosing
- granulomatous
- smoking related
- eosinophil
fibrosing diseases
usually interstitial pneumonia non specific interstitial pneumonia cryptogenic organising pneumonia autoimmune related pneumoconiosis
granulomatous
sarcoid
hypersensitivity pneumonitis/extrinsic allergic alveolitis
idiopathic pulmonary fibrosis
unknown cause
temporally heretrogenous process
fibroplastic foci - focal areas of nodules of fibrous tissue
honey comb lung
fibroplastic foci
focal areas of nodules of fibrous tissue
idiopathic pulmonary fibrosis survival
<5 years
hypersensitivity pneumonitis
inhalation and exposure to antigen
eg. spores of bacteria, fungi, mycobacteria, animal proteins
clinical names of hypersensitivity pneumonitis
depends on in the causative antigen eg. air conditioner lung byssinosis farmer's lung bird fancier's lung hot tub lung
air conditioner lung
due to thermophilic bacteria
byssinosis
in textile workers due to fibres from cotton, linen and hemp
endotoxin from bacterial contamination of cotton may play a role
framer’s lung
from mouldy hay containing spores of thermophilic actinomycetes
acute hypersensitivity pneumonitis
influenza like syndrome a few hours after exposure to an antigen
subacute hypersensitivity pneumonitis
slowly progressive failure over weeks to months
gas transfer may be impeded
chronic hypersensitivity pneumonitis
slowly progressive and insidious respiratory failure
restrictive pattern on pulmonary function tests
non specific interstitial pneumonia
temporally uniform homogenous appearance
cryptogenic organising pneumonia
cough and dyspnoea
plugs of loose organising connective tissue in alveolar ducts, alveoli and bronchioles
temporally homoogenous
some recover spontaneously, most recover with steroids
connective tissue diseases
rheumatoid arthritis, systemic lupus erythematosus, scleroderma, and other connective tissue disease may have pulmonary manifestations
sarcoidosis
systemic granulomatous disease unknown aetiology often liver, lung, brain, lymph nodes hilar lymphadenopathy or lung involvement non necrotising granulomas
pneumoconioses
pulmonary fibrosis due to inhaled dust
anthracosis/ coal worker’s pneumoconiosis
silicosis
asbestosis
asbestos associated diseases
localised pleural plaques pleural effusions asbestosis mesothelioma laryngeal and colonic carcinoma