Restrictive Lung Disease Flashcards
What does restrictive lung disease cause a decrease in
Total lung capacity
2 major categories of restrictive lung disease
Intrinsic
Extrinsic
What causes intrinsic restrictive lung disease
Lung parenchyma inflammation and scarring
What causes extrinsic restrictive lung disease
Abnormal function of chest wall, pleura, and neuromuscular apparatus
Which type of restrictive lung disease decreases alveolar-arterial gas transfer, and leads to exudate and debris in lungs
Intrinsic
Which type of restrictive lung disease causes impaired ventilator function and respiratory failure
Extrinsic
DPLD
Diffuse parenchymal lung diseases
Is interstitial lung disease a type of intrinsic lung disease or is intrinsic lung disease a type of interstitial lung disease
Interstitial is a type of intrinsic
3 major interstitial lung diseases
Idiopathic pulmonary fibrosis
Sarcoidosis
Pneumoconiosis
Are interstitial lung diseases usually common or rare
Rare
Idiopathic pulmonary fibrosis risk factors
Smoking
Chronic viral infections
Abnormal acid reflux
Family history
Why is breathing and oxygen exchange restricted in idiopathic pulmonary fibrosis
Scarring/honeycombing of lungs
What causes scarring and honeycombing of lungs in idiopathic pulmonary fibrosis
Collagen deposits and fibrotic plaques
What is believed to cause idiopathic pulmonary fibrosis
Decreased epithelial cell integrity
Accelerated age associated changes
Exaggerated fibroblast expansion
What lung changes are caused by idiopathic pulmonary fibrosis
Traction bronchiectasis
Alveolar remodelling - collagen + fibrotic plaques
Parenchymal fibrosis
Idiopathic pulmonary fibrosis signs and symptoms
Exertional Dyspnoea
Clubbing
Dry cough
Bibasilar inspiratory crackles
Restrictive flow volume spirometry
DLCO - diffusing capacity of the lungs for CO
Quantity of CO transferred per minute from alveolar gas to RBCs
DLCO equation
Lung surface area available for gas exchange (Va) X rate of capillary blood CO uptake (Kco)
How does interstitial lung disease affect DLCO
Decrease
What chest HRCT findings confirm idiopathic pulmonary fibrosis
Reticular changes associated with traction bronchiectasis and honeycombing
Recommended Idiopathic pulmonary fibrosis drugs
Pirfenidone
Nintedanib
Antacid therapy
Pirfenidone
Anti fibrotic agent used in COPD treatment
Pirfenidone adverse affects
GI effects
Photosensitivity
Anorexia
Skin rash
Liver toxicity
Nintedanib
Tyrosine kinase inhibitor
Nintedanib adverse effects
Diarrhoea
Weight loss
Liver toxicity
Antacid therapy adverse effects
Infection
Cognitive function
MI
Non pharmacotherapy idiopathic pulmonary fibrosis treatments
Pulmonary rehab
Long term oxygen
Lung transplant
Sarcoidosis
Inflammatory disease causing multi system granulomas due to immune system overdrive
Why does sarcoidosis often not require treatment
Acute and self limiting
Sarcoidosis symptoms
Dry eyes
Blurry vision
Enlarged lymph nodes
Hacking cough
Coughing blood
Heart complications
Liver enlargement
Spleen enlargement
Joint pain
Arthritis
Knee swelling
Rashes
Lupus pernio
Erythema nodosum
Skin lesions on back
Subcutaneous nodules
What causes sarcoidosis
Immune system overdrive
Sarcoidosis clinicoradiographic data
Bilateral Hilary adenopathy in chest radiograph
Lofgren syndrome
Lofgren syndrome
Erythema nodosum rash & bilateral hilar adenopathy on CXR +/- fever + arthritis
Parts of sarcoidosis diagnosis
Biopsy
Clinicoradiographic data
Exclusion of other diagnosis
Sarcoidosis drugs
Corticosteroids
Methotrexate
Folic acid
Azathoprine
Leflunomide
Mycophenolate
Refractory sarcoidosis treatment
Infliximab
Corticosteroid side effects
Osteoporosis
Central adiposity
How do corticosteroids improve cpsarcoidosis
Decrease pro inflammatory cell survival
