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Pulmonary > Restrictive/Inflammatory Lung Disease > Flashcards

Restrictive/Inflammatory Lung Disease Flashcards

1
Q

How is Restrictive lung disease defined?

A

By reduced lung volumes:

TLC <80%

FRC (TGV) <80%

Symmetrically reduced FEV1 and FVC

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2
Q

How does compliance relate to Volume and Pressure?

A

Compliance is deltaV/deltaP

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3
Q

At a given pressure, volume is lower in ____________ (restrictive/obstructive) diseases. This disease makes it hard to _____________ (inhale/exhale)

A

Restrictive

Hard to inhale because of decreased compliance

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4
Q

At a given pressure, volume is higher in ____________ (restrictive/obstructive) diseases. This disease makes it hard to _____________ (inhale/exhale)

A

Obstructive

Hard to exhale (this is a gross simplification. It increases resistive work and therefore both inspiration and expiration)

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5
Q

How can you distinguish between Restrictive Lung Disease and Restrictive Physiology?

A
  1. Slope of P-V curve is reduced in restrictive lung disease
  2. DLCO/VA is reduced in RLD
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6
Q

What causes gas exchange to decrease in restrictive lung disease?

A
  1. Loss of Alveolar surface area
  2. Diffusion limitation (thickening)

*Don’t cause significant gas exchange problems unless severe*

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7
Q

What would go on the differential for an acute Restrictive Process?

A
  1. Pulmonary edema
  2. ARDS/DAD (caused by injury)
  3. Pneumonia
  4. Plueral Effusion
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8
Q

What would go on the differential for an acute Restrictive Process?

A
  1. Interstitial lung disease
  2. Plueral Fibrosis/plaque
  3. Plueral effusion
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9
Q

What 2 things must be true in order to diagnose a mixed obstructive and restrictive disease?

A
  1. Reduced Lung Volumes (Restrictive)
  2. FEV1/FVC
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10
Q

What is ILD?

A

Interstitial Lung Disease

It is a bunch of disorders characterized by inflammation or scarring of lungs.

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11
Q

The most common cause of ILD is….

A

Systemic diseases such as:

  • RA
  • Scleroderma
  • Lupus
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12
Q

What physical exam finding are classic for ILD?

A

“Velcro-like” crackles.

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13
Q

What is the treatment pattern for treating ILD?

A
  1. Remove offending exposure
  2. Immunosuppression
  3. Oxygen
  4. Transplant
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14
Q

What do you use to treat IPF?

A

Idiopathic Pulmonary Fibrosis: Use Nintedanb and Pirfenidone

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15
Q

What does imaging of IPF show?

A
  1. Reticulation around the edge of lungs (normally clear within 1-2 cm)
  2. Honeycombing**
  3. Ground Glass infiltrate

** differentiates between Nonspecific Interstitial Pneumonia and IPF

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16
Q

True or False: Smoking may result in ILD after pts are 60 yo.

A

True

17
Q

Smoking related ILD involving a young smoker, with cysts and nodules on a CT is most likely:

A

Pulmonary Langerhans Cell Histiocytosis (PLCH)… man I bet it took them forever to come up with that acronym.

18
Q

Which pneumonia is diagnosed by extracting fluid and observing eosinophils? What other condition does this mimic?

A

Acute/Chronic Eosinophilic Pneumonia.

Acute Mimics ARDS

19
Q

Chronic Eosinophilic Pneumonia is usually associated with:

A

Asthma

20
Q

What is the hallmark of Sarcoidosis?

A

Non caseating granuloma (collection of inflammatory cells)

21
Q

What is the usual presentation of Sarcoidosis?

A

Usually before 40yo. Commonly affects African Americans more than White Americans. Has bulky lymphnodes on chest Xray

22
Q

True or false, sarcoidosis is caused by TB.

A

False: Granulomas can be caused by TB as well as sarcoidosis. Sarcoidosis is idiopathic.

23
Q

NSIP (nonspecific interstitial pneumonia) differs from IPF in that:

A
  1. Pts are more likely to be younger and female.
  2. It responds to anti-inflammatory therapy
24
Q

What is organizing pneumonia?

A
  1. Formerly called BOOP.
  2. May be idiopathic or secondary to CVD, drugs, HP, aspiration.
  3. Noninfectious.
  4. Treated with steroids
25
Q

Lymphangioleiomyomatosis is characterized by

A
  1. Peribronchovascular proliferation of smooth muscle cells that form cysts and nodules.
  2. Mutation in tuberous sclerosis gene
  3. Renal tumors
26
Q

What can cause chest wall restriction?

A

Basically anything from the skin in:

  • Skin disorders
  • Obesity
  • Severe scoliosis
  • Respiratory muscles
  • Pleural Disease

Pulmonary (36 decks)

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