Restrictive lung disease Flashcards
Restricted lung disease - volumes
- decreased FVC
2. decreased TLC
Restricted lung disease - pulmonary function test
FEV1/FVC >= 80%
Restricted lung disease - types
- poor brbeathing mechanics
2. Interstitial lung diseases
Restricted lung disease - poor breathing mechanics properties
- extrapulmonary
- peripheral hypoventilation
- normal A-a gradient
Restricted lung disease - Interstitial lung disease properties
- decreased pulmonary diffusing capacity
2. increased A-a gradient
Restricted lung disease - poor breathing mechanics –> situations (and causes)
- poor muscular effort (polio, myasthenia gravis)
2. poor structural apparatus (scoliosis, morbid obesity)
Restricted lung disease - causes of poor muscular effort
- polio
2. myasthenia gravis
Restricted lung disease - causes of poor structural apparatus
- scoliosis
2. morbid obesity
Langerhans cell histiocytosis - also called
eosinophilic granuloma
Restricted lung disease - drug toxicity
- bleomycin 2. busulfan
3. amiodarone 4. methotrexate
idiopathic pulmonary fibrosis - pathophysiology
repeated cycles of lung injury and wound healing with increased collagen deposition
sarcoidosis images and histology
- bilateral hilar lymphadenopathy
2. noncaseating granuloma in multiple organs
sarcoidosis - ‘‘paraneoplastic’’
- elevated serum ACE
2. hypercalcemia
sarcoidosis - pathophysiology of hypercalcemia
1‐α hydroxylase activity of epithelioid histiocytes converts vitamin D to its active form
Restricted lung disease - causes of interstitial lung capacity (10)
- ARDS 2. NRDS 3. Pneumoconioses 4. Sarcoidosis 5. idiopathic pulm fibrosis 6. Goodpasture 7. Wegener
- Eosinophilic granuloma 9. hypersensitive pneumonitis
- drugs
Idiopathic pulmonary fibrosis - mechanism
repeated cycles of lung injury and wound healing with increased collagen deposition
Idiopathic pulmonary fibrosis - histology
honeycomb
Idiopathic pulmonary fibrosis - special characteristic in clinical presentation
digital clubbing
normal FEV1/FVC
80%
obstructive FEV1/FVC
less than 80%
restrictive FEV1/FVC
more than 80%
obstructive lung volumes
increased TLC FRC RV
restrictive vs obstructive according FEV1
obstructive: FEV1 is MORE dramatically reduced compared to FVC
restrictive: FEV1 is LESS dramatically reduced compared to FCV
restrictive vs obstructive according FEV1
obstructive: FEV1 is MORE dramatically reduced compared to FVC
restrictive: FEV1 is LESS dramatically reduced compared to FCV
restrictive vs obstructive according spirometry loop
obstructive –> loop shifts to the left
restrictive –> loop shifts to the right