restrictive lung disease Flashcards
what are 4 non resp/cardiac causes of SOB
thryotoxicosis; anaemia/haemorrhage; obesity; anxiety
what are 4 areas that can be implicated in causing SOB when damaged (resp)
airways; pulomonary circualtion; parenchyma; plueral + chest wall - the last two are restictive
examples of restrictive extra-pulmonary conditions (5)
all neuromuscular:
diaphragmatic paralysis
cervicle spine injury
myasthenia gravis
guillain-barre
muscular dystrophies
examples of restrictive extraparenchymal conditions (3)
affect chest wall expansion:
kyphoscoliosis
obesity
AnkSpon (bamboo spine affects the rib-spine joint)
classic signs of a diffuse parenchymal lung disease (3)
gradual onset SOB; frequent dry, non-productive cough; inspiratory crepitations
4 specific causes of diffuse parenchymal lung disease
drug induced; hypersensitivity pneumonitis; connective tissue disease; occupational
what is the interstitium (what does it contain and how is it adapted to promote GE)
the space between alveolar membranes and the endothelial cells of the interstitial capillaries; contains the extra cellular matrix (collagen, elastin, glycosaminoglycans etc.), fibroblasts, immune cells etc.;
adapted to being a small surrounding layer which promotes GE to more easily occur (less diffusion distance)
what are 3 drugs that can result in ILD
bleomycin; amiodarone; nitrofuratonin
classification, epidemiology, onset and CT of idiopathic pulmonary fibrosis (usual intersitial pneumonia)
idiopathic intersitial pnuemonia; 50-80yro affects M>F; insidious onset and had exacerbations; CT - honeycombing with possible traction bronchiectasis
classification, epidemiology, associated condition and CT of non-specific interstitial pnuemonia
IIP; 40-50yro affects M=F; associated with connective tissue disease; CT - ground glass (suggestion of inflammation), reticular shadowing
classification, onset and CT of cryptogenic organising pneumonia
IIP; sub-acute (recovers well w steroids); CT - consolidation or nodules
respiratory bronchiolitis CT
patchy ground glass, centrilobular micronodules, regional attenuation
classification, onset and CT of acute interstitial pneumonia (hammond-rich syndrome)
IIP; rapidly progressing acute onset (high mortality); CT - consolidation, ground glass
name 2 granulmonatous ILD
sarcoidosis; hypersensitivity pneumonitis
what should a preceeding pnuemothorax in a mid-30s woman cause suspicion of and what is the treatment
lymphangioleimomatosis (LAM) - treat with sirolimus
how can the hands help you in diagnosis of an ILD
show signs of connective tissue disease (swan neck, scleroderma, Z deformity etc.); show clubbing, tar staining etc.
what are 3 kinds of lung biopsies that can be done and what is each used for
- transbronchial biopsy - for peribronchial disease e.g. sarcoidosis, diffuse disease so only need a small sample
- cryobiopsy - detects other parenchymal disease, more invasive and takes a bigger sample an there is a higher risk of bleeding
- video assisted throacoscopic biopsy (VAT) - only done if really required, used for sub-pleural diseases or IPF
what 2 drugs are highly associated with deveolpment of an ILD
nitrofurantonin; amiodarone
