Restrictive lung disease

Question 1

Restrictive lung disease

Answer 1

Low lung volumes (low FVC and TLC)

PFT: FEV1/FVC ratio > 80%

Question 2

Restrictive lung disease:

types

Answer 2

1) poor breathing mechanics (normal A-a gradient)

2) interstitial lung disease (high A-a gradient)

Question 3

Restrictive lung disease:

Poor breathing mechanics

Answer 3

Extrapulmonary, peripheral hypoventilation, normal A-a

1) poor muscle effort: polio, myasthenia gravis
2) poor structural appartus: scoliosis, morbid obesity

Question 4

Restrictive lung disease:

Interstitial lung disease

Answer 4

Pulmonary, lowered diffusing capacity, high A-a

1) ARDS
2) Neonatal respiratory distress syndrome (hyaline membrane disease)
3) pneumoconioses (anthracosis, silicosis, abestosis)
4) sarcoidosis: bilateral hilar LN, noncaseating granuloma, high ACE and Ca2+
5) idiopathic pulm fibrosis
6) Goodpasture’s syndrome
7) Wegener’s
8) Langerhans cells histiocytosis (eosinophilic granuloma)
9) Hypersensitivity pneumonitis
10) Drug toxicity (bleo, busulfan, amio, MTX)