Restrictive Lung disease

Question 1

What is the definition of restrictive lung disease

Answer 1

• defined spirometry as less than 0.7, both reduced FEV1/FVC

Question 2

Is the TLCO and KCO reduced or raised in restrictive lung disease

Answer 2

It is reduced

Question 3

What are the two main headings for the causes of restrictive lung disease

Answer 3

• Extrinsic

- Intrinsic

Question 4

What are the extrinsic causes of restrictive lung disease

Answer 4

• sclerosis
• Kyphosis
• Neuromuscular wall weakness
• chest wall deformity
• obesity

Question 5

What are the two headings for the causes of intrinsic lung disease

Answer 5

• Upper lobe

- Lower lobe

Question 6

What are the upper lobe causes of intrinsic lung disease

Answer 6

BREAST CLAPS

• Burillosis
• Radiation
• Extrinsic allergic alveolitis
• Ankylosing spondylitis
• Sarcoidosis
• TB
• Coal worker pneumocosis
• Langerhan cell
• Allergic bronchopulmonary aspergillosis
• Psoriatic arthritis
• Sillicosis

Question 7

What are the lower lobe causes of intrinsic lung disease

Answer 7

DR CIA

• D - drugs
• R - rheumatoid arhtirits
• C - connective tissue
• I - idiopathic pulmonary fibrosis
• A - asbestosis

Question 8

What are the drug causes of intrinsic lung disease

Answer 8

• Methotrexate
• Nitrofurantoin
• bleomycin
• Amiodarone

Question 9

What are the connective tissue causes of intrinsic lung disease

Answer 9

• SLE

- Anti JO1

Question 10

In sarcoidosis what levels are risen

Answer 10

• Increase in serum ACE

- increase in calcium

Question 11

Why does calcium increase in sarcoidosis

Answer 11

• increases due to alveolar macrophages producing hydroxylation of vitamin D which produce calcium

Question 12

How does scoliosis look like on a CXR

Answer 12

• egg shall classification in hilarity lymph nodes

Question 13

What would be your examination findings on someone with restrictive lung disease

Answer 13

General 
Hands 
- arthritic type hands 
- psoriatic lesions 
- rough coarse hands 
- peripheral signs 
- clubbing 
- uveitis 
- dry mouth 

Chest

• use of accessory muscles
• reduced lung expansion
• dull - if high amount of consolidation
• fine crackles
• bronchial breathing

Question 14

What are the investigations of restrictive lung disease

Answer 14

Bedside BUMMERs

• B = Bloods - FBC, U+E, CRP
• U = urine = Urine dipstick, microbiology
• M= Microbiology = sputum culture,
• M= Monitoring = vital signs (HR, RR, Temp, BP, sPO2)
• E = ECG/echo
• R = radiology - CXR
• S =Special tests - spirometry, peak flow etc