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Pulmonary > Restrictive and Interstitial Lung Disease > Flashcards

Restrictive and Interstitial Lung Disease Flashcards

1
Q

What happens to Total lung capacity (TLC) in restrictive diseases?

A

< 80% → restriction

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2
Q

What are anatomical disease that lead to Restrictive Respiratory Diseases?

A

Neuromuscular Weakness
Chest Wall Disorders
Pleural Disease
Lung Parenchymal Disease

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3
Q

T or F: there is airway obstruction in restrictive disease

A

F:
no airway obstruction (FEV1/FVC ≥ 0.75)
BUT BOTH low FEV1 and FVC

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4
Q

What happens to lung volumes in restrictive diseases?

A

Low TLC, RV, VC and FRC

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5
Q

What happens to diffusion capacity (ie. DLCO) in restrictive resp. diseases?

A

Diffusion capacity may be normal or decreased in restrictive respiratory disorders
ie. Abnormal lung parenchyma → DLCO < 80%

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6
Q

T or F: DLCO is not specific to restrictive or obstructive disease

A

T

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7
Q

Which obstructive diseases have normal DLCOs?

A
  • asthma

- COPD

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8
Q

Which obstructive diseases have lower DLCOs?

A
  • emphysema
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9
Q

Which restrictive diseases have normal DLCOs?

A
  • obesity
  • chest deformity
  • neuromuscular weakness
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10
Q

Which restrictive diseases have lower DLCOs?

A
  • interstitial lung disease
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11
Q

What normal values for DLCO?

A

100% plus/minus 20% –> 80-120%

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12
Q

What are some restrictive resp. diseases that are due to neuromuscular weakness?

A 
Spinal cord injury or disease
Anterior horn cell disease (ALS, polio, rabies)
Guillain-Barré Syndrome
Diaphragmatic paralysis
Myasthenia gravis
Botulism
Hereditary and acquired myopathies
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13
Q

What can cause chest wall abnormalities?

A

Trauma/fractures/pain
Morbid obesity
Severe kyphoscoliosis
Subdiaphragmatic pathology (recent abdominal surgery)

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14
Q

What some diseases of the pleura that cause restrictive resp. disease?

A

Large pleural effusions
Pleural plagues
Fibrothorax
Mesothelioma

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15
Q

What is interstitial lung disease?

A

Disorders of the lung parenchyma

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16
Q

What are signs of ILD?

A 
Clubbing
Crackles - “velcro”
Inspiratory Squeaks
Cyanosis
Cor pulmonale
17
Q

What are radiographic features on a xray indicative of ILD?

A

Reticular
Nodular
Reticulonodular

18
Q

Whats is the etiology of ILD?

A 
Six I’s:
Inflammatory
Immunologic
Infiltrative
Inhalational
Iatrogenic
Idiopathic
19
Q

What are some inflammatory/immunologic causes of ILD?

A

Sarcoidosis
Vasculitis
Interstitial pneumonitis associated with collagen vascular diseases (rheumatoid arthritis, systemic sclerosis, etc.)

20
Q

What are some infiltrative causes of ILD?

A

Lymphangitic carcinomatosis
Metastatic carcinoma
Lymphoma
Amyloidosis

21
Q

What are some inhalational causes of ILD?

A 
Asbestosis
Silicosis
Hypersensitivity pneumonitis:
- Farmer’s lung
- Bird Fancier’s disease
22
Q

What are some iatrogenic causes of ILD?

A 
Many drugs can lead to the development of ILD:
Chemotherapy (bleomycin)
Antibiotics (nitrofurantoin)
NSAID’s (naproxen)
Cardiac (amiodarone)
Illicit (cocaine)
Immunosuppressants (methotrexate)
23
Q

What are some idiopathic causes of ILD?

A

Idiopathic pulmonary fibrosis
Familial pulmonary fibrosis
Histiocytosis X

24
Q

What is sarcoidosis?

A

An inflammatory disorder of unknown etiology; can affect any tissue

25
Q

What is the treatment for sarcoidosis?

A

systemic steroids (if severe)

26
Q

What some radiographic and CT features of sarcoidosis?

A

CXR- bilateral hilar lymphadenopathy +/- reticulonodular interstitial changes
Non-caseating granulomatous inflammation

27
Q

What is the prognosis of idiopathic pulmonary fibrosis?

A

Gradual progression to respiratory failure and death – within 10 years

28
Q

What are physical findings of idiopathic pulmonary fibrosis?

A

Clubbing
Bibasilar, late inspiratory, Velcro crackles
Cor pulmonale – end stage

29
Q

What is a CT feature of IPF?

A

Honeycombing

30
Q

What is a CXR feature of IPF?

A

extensive interstitial markings

Pulmonary (25 decks)

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