Restrictive Lung Disease Flashcards
what is the main pathology behind restrictive lung disease?
alveolar barrier to O2 exchange
describe PaO2 and PaCO2 in restrictive lung disease?
low PaO2
normal PaCO2
what are the 2 types of pulmonary oedema?
cardiac pulmonary oedema
non cardiac pulmonary oedema
why does cardiac pulmonary oedema occur?
due to raised pulmonary pressure in the veins due to back pressure from the heart
why does non cardiac pulmonary oedema occur?
leaky pulmonary capillaries (can be caused by sepsis or trauma- ARDS)
what are the 3 major causes of consolidation of the alveolar air spaces?
infective pneuonia
infarction
others
what 2 types of infarction can occur in the lung and thus cause consolidation of the alveolar air?
pulmonary embolism
vasculitis
what is the name of the non-infectious type of pneumonia which causes alveolar air space consolidation?
cryptogenic organizing pneumonia
what disease is associated with cryptogenic organising pneumonia?
rheumatoid disease
what anti-arrhythmic medication is associated with cryptogenic organising pneumonia?
amiodarone
what type of hypersensitivity reaction is extrinsic allergic alveolitis?
type 3: immune-complex mediated
hypersensitivity pneumonitis
what type of hypersensitivity reaction is sarcoidosis?
type 4:delayed hypersensitivity
what 5 important signs can be caused by sarcoidosis?
- lymphadenopathy
- erythema nodosum
- uveitis
- myocarditis
- neuropathy
what are the 2 causes of fibrosing alveolitis?
rheumatoid associations
cryptogenic fibrosing alveolitis
what 6 important diseases cause an inflammatory infiltrate of the alveoler walls (alveolitis) and so cause restrictive disease?
- extrinsic allergic alveolitis
- sarcoidosis
- drug induced alveolitis
- pneumoconiosis
- fibrosing alveolitis
- autoimmune alveolitis (eg SLE)
what is pneumoconiosis?
dust-disease
what two types of pneumoconiosis is there?
fibrogenic
non fibrogenic
what are the 2 important types of fibrogenic pneumoconiosis?
asbestosis
silicosis
what are 3 important types of non-fibrogenic pneumoconiosis?
siderosis (iron)
stanosis (tin)
baritosis (barium)
what are the 6 important features of the clinical syndrome of restrictive lung disease?
- breathless on exertion
- cough (with no wheeze)
- finger clubbing
- inspiratroy lung crackles
- central cyanosis
- pulmonary fibrosis (late stage)
why does pulmonary fibrosis occur in late stage restrictive disease?
as a response to the chronic inflammation
what are 4 key questions you must ask to find out the cause of restrictive disease?
occupation?
medications?
pets?
arthritis?
in restrictive disease, what is the DLCO?
reduced
in restrictive disease what is the PEFR like?
normal
in restrictive disease what is FEV1, FVC and FEV1/FVC like?
reduced FEV1
reduced FVC
normal ratio
in sarcoidosis, what 3 findings would you expect when testing serum?
raised ACE
raised Ca
increased inflammatory markers
why do you use an echocardiogram in diagnosing restrictive lung disease?
to rule out LVF
how do you treat restrictive lung disease?
- remove trigger (eg dust, drug, allergen)
- treat any inflammation with immunosupressives
- give oxygen if hypoxaemia
- lung trasplant
what is the 1st line treatment for restrictive lung disease?
systemic corticosteroids
eg oral prednisolone