restrictive Flashcards
what parts of the lung are normally affected in restrictive lung disease
lung interstitial eg alveoli, terminal bronchi (can be skeletal, obesity etc)
in restrictive lung disease how is the FVC, FEV1, PEFR and gas exchange affected
both reduced, normal PEFR and ratio, impaired O2 but CO2 normal
what are the main types of interstitial lung disease
sarcoidosis, EAA, idiopathic pulmonary fibrosis (IPF) and pneumoconiosis (occupational lung diseases)
what is sarcoidosis
type IV hypersensitivity, non-caeseating granulomous, unknown cause - less common in smokers
name some symptoms of sarcoidosis
erythema nodosum (swollen fat), uveitis (red, swollen eyes), swollen nodes in lungs, Bilateral hilar lymphadenopathy, granulomas
what are the investigations for sarcoidosis
CXR, biopsy, lung function test, bloods (ACE, raised Ca)
what is the treatment for sarcoidosis
acute is nothing, chronic oral steroids if organs affected
what is hypersensitivity pneumonitis (EAA)
extrinsic allergic alevolitis, type III (+IV) hypersensitivity. Is a reaction to an inhaled antigen, normally farmers lung
who is likely to get EAA
farmers, bird fanciers, malt workers
what are the signs and symptoms of EAA
cough, breathlessness, fever, malaise, myalgia (pain in muscle), crackles in chest, hypoxia, no wheeze
how do you treat EAA
O2, steroids, avoid antiges
what are the signs and treatment of chronic EAA
progressive breathlessness from low dose exposure over a long time, progressive SOB + cough, fibrosis in upper zones, PFTs, oral steroids
what is the most common ILD
idiopathic pulmonary fibrosis
what are the symptoms of IPF
dry cough, clubbing, bilateral fine inspiratory crackles, cyanosis
what are the investigations for IPF
CXR and CT (honeycombing), PFT’s = restrictive
how do you treat IPF
anti-fibrotic drugs which are expensive, O2, lung transplant (not very curable)
what is pneumoconiosis
occupational lung disease
what is normal and complicated pneumoconiosis
simple: abnormal CXR but normal lung function, complicated: progressive fibrosis and SOB
what causes coal workers pneumoconiosis and silicosis
coal and quartz
what causes asbestos related ILD
exposure to asbestos eg mining, construction, boilers
what can asbestos cause
fibrosis, mesothelioma (pleural cancer)
what are the main symptoms of restrictive disease
progressive SOB, cough no wheeze, clubbing, insp crackles, fibrosis
apart from diffuse parenchymal lung disease, what can cause restrictive disease
skeletal eg kyphoscoliosis and rib fractures.
muscle weakness eg Gullaine Barre - immune attacks PNS –> muscle weakness
