Restrictive and Interstitial Lung Disease Flashcards
What happens to Total lung capacity (TLC) in restrictive diseases?
< 80% → restriction
What are anatomical disease that lead to Restrictive Respiratory Diseases?
Neuromuscular Weakness
Chest Wall Disorders
Pleural Disease
Lung Parenchymal Disease
T or F: there is airway obstruction in restrictive disease
F:
no airway obstruction (FEV1/FVC ≥ 0.75)
BUT BOTH low FEV1 and FVC
What happens to lung volumes in restrictive diseases?
Low TLC, RV, VC and FRC
What happens to diffusion capacity (ie. DLCO) in restrictive resp. diseases?
Diffusion capacity may be normal or decreased in restrictive respiratory disorders
ie. Abnormal lung parenchyma → DLCO < 80%
T or F: DLCO is not specific to restrictive or obstructive disease
T
Which obstructive diseases have normal DLCOs?
- asthma
- COPD
Which obstructive diseases have lower DLCOs?
- emphysema
Which restrictive diseases have normal DLCOs?
- obesity
- chest deformity
- neuromuscular weakness
Which restrictive diseases have lower DLCOs?
- interstitial lung disease
What normal values for DLCO?
100% plus/minus 20% –> 80-120%
What are some restrictive resp. diseases that are due to neuromuscular weakness?
Spinal cord injury or disease Anterior horn cell disease (ALS, polio, rabies) Guillain-Barré Syndrome Diaphragmatic paralysis Myasthenia gravis Botulism Hereditary and acquired myopathies
What can cause chest wall abnormalities?
Trauma/fractures/pain
Morbid obesity
Severe kyphoscoliosis
Subdiaphragmatic pathology (recent abdominal surgery)
What some diseases of the pleura that cause restrictive resp. disease?
Large pleural effusions
Pleural plagues
Fibrothorax
Mesothelioma
What is interstitial lung disease?
Disorders of the lung parenchyma
What are signs of ILD?
Clubbing Crackles - “velcro” Inspiratory Squeaks Cyanosis Cor pulmonale
What are radiographic features on a xray indicative of ILD?
Reticular
Nodular
Reticulonodular
Whats is the etiology of ILD?
Six I’s: Inflammatory Immunologic Infiltrative Inhalational Iatrogenic Idiopathic
What are some inflammatory/immunologic causes of ILD?
Sarcoidosis
Vasculitis
Interstitial pneumonitis associated with collagen vascular diseases (rheumatoid arthritis, systemic sclerosis, etc.)
What are some infiltrative causes of ILD?
Lymphangitic carcinomatosis
Metastatic carcinoma
Lymphoma
Amyloidosis
What are some inhalational causes of ILD?
Asbestosis Silicosis Hypersensitivity pneumonitis: - Farmer’s lung - Bird Fancier’s disease
What are some iatrogenic causes of ILD?
Many drugs can lead to the development of ILD: Chemotherapy (bleomycin) Antibiotics (nitrofurantoin) NSAID’s (naproxen) Cardiac (amiodarone) Illicit (cocaine) Immunosuppressants (methotrexate)
What are some idiopathic causes of ILD?
Idiopathic pulmonary fibrosis
Familial pulmonary fibrosis
Histiocytosis X
What is sarcoidosis?
An inflammatory disorder of unknown etiology; can affect any tissue
