restrictive lung disease Flashcards
what are some causes to thoracic restriction?
skeletal (kyphoscoliosis, ankylosing spondylisis, rib fracture)
muscle (myopathy, neuropathy, gullian barre, myasthenia gravis)
abdominal obesity/ascites
what does thoracic restriction cause?
chronic alveolar underventillation with low oxygen, raised carbon dioxide and reduced lung volumes
how can diffuse parenchymal lung disease (DPLD) be classified?
acute, episodic, chronic (occupational or systemic disease), chronic idiopathic
what is DPLD?
a disease of the lung parenchyma (i.e alveolar walls & lumen)
what is the pathophysiology of DPLD?
impaired gas exchange (alveolar-arteriolar barrier), CO2 exchange normal as ventilation normal
(low oxygen & normal CO2)
what can fluid in the alveolar spaces be caused by?
cardiac pulmonary (LVF) & non-cardiac pulmonary oedema (leaky capillaries - sepsis & trauma aka ARDS)
what can cause consolidation of alveolar spaces?
pneumonia, infarction, BOOP, rheumatoid disease
what can cause inflammatory infiltrate of alveolar walls (alveolitis)?
granulomatous alveolitis, sarcoidosis, drugs (amidarone, methotrexate, gold), toxic fumes (chlorine), fibrosing alveolitis, auto-immune, pneumoconiosis (fibrinogenic e.g asbestosis vs. non-fibronogenic e.g baritosis), neoplasm, eosinophilic (allergic)
what is the general presentation of DPLD?
breathlessness on exertion, cough with no wheeze, clubbing, inspiratory crackles, central cyanosis, pulmonary fibrosis
how do we diagnosis DPLD?
restrictive spirometry, low TLCO, arteriolar oxygen desaturation (low oxygen), serology, bloods, CXR, ECG, CT, bronchoalveolar lavage/induced sputum, biopsy
how do we treat DPLD?
avoidance, immunosuppressives for inflammation, oral steroids, pirfenidone (anti-fibrotic for IPF), acetyl cysteine (anti-oxidant for IPF), oxygen, transplant
