Restrictive Lung Disease

Question 1

What is DPLD?

Answer 1

Diffused Parenchymal Lung Disease i.e. ILD

Question 2

Lung parenchyma

Answer 2

Portion of the lung involved in gas transfer (alveoli, alveolar ducts and bronchioles)

Question 3

What are the main causes of DPLD? (8)

Answer 3

1. Fluid in alveolar air spaces
2. Consolidation of alveolar air spaces
3. Inflamed infiltrated of alveolar walls
4. Drugs and toxins
5. Carcinogens
6. Eosinophilic type I/III reactions
7. Autoimmune

Question 4

2 causes of fluid in alveolar spaces

Answer 4

Increased pulmonary venous pressure (Cardiac LVF)
Leaky capillaries (ARDS)

Question 5

2 causes of consolidation of alveolar spaces

Answer 5

Pneumonia

Infarction - PE or vasculitis

Question 6

2 causes of inflammation of alveolar walls

Answer 6

Extrinsic allergic alveolitis - farmer’s lung, bird fanciers lung
Sarcoidosis

Question 7

Siderosis

Answer 7

Iron

Question 8

Stanosis

Answer 8

Tin

Question 9

Baritosis

Answer 9

Barium

Question 10

Toxic gas which causes alveolitis?

Answer 10

Chlorine

Question 11

Clinica presentation

Answer 11

SoB on exertion
Cough - no wheeze
Clubbing
Lung crackles
Central cyanosis

Question 12

Treatment - 1st line

Answer 12

Systemic corticosteroids - oral prednisolone

Question 13

Treatment - 2nd line

Answer 13

Oral azathioprine or anti-fibrotic agent

Question 14

What type of hypersensitivity reaction is sarcoidosis?

Answer 14

Type 4

Question 15

Is sarcoidosis more or less common in smokers?

Answer 15

Less

Question 16

CXR in sarcoidosis?

Answer 16

Bilateral hilar lymphadenopathy

Question 17

What can be given for chronic sarcoidosis?

Answer 17

Oral steroids

Immunosupression

Question 18

What type of hypersensitivity reaction is extrinsic allergic alveolitis?

Answer 18

Type 3

Question 19

What is another name for extrinsic allergic alveolitis?

Answer 19

Hypersensitive pneumonitis

Question 20

Give examples of extrinsic allergic alveolitis

Answer 20

Farmer’s lung
Coal workers lung
Mushroom workers lung
Pigeon fancier’s lung

Question 21

Treatment for acute EAA?

Answer 21

Oxygen, steroid and avoidance

Question 22

Where does EAA most likely effect and why?

Answer 22

Upper lobes as there are ventilated more frequently

Question 23

What is the most common type of ILD?

Answer 23

Idiopathic Pulmonary Fibrosis

Question 24

Is IPF an inflammatory disease?

Answer 24

No

Question 25

Treatment for Idiopathic pulmonary fibrosis?

Answer 25

Oxygen if hypoxic

Lung transplant in young patients

Question 26

What is asbestosis?

Answer 26

Diffused pulmonary fibrosis and restrictive defects

Question 27

What is the early and late stage of ILD?

Answer 27

Alveolitis and then fibrosis

Question 28

What causes ILD?

Answer 28

Minerals, drugs, radiation, mouldy hay, avian proteins or idiopathic

Question 29

What are the two ways a biopsy can be taken for ILD?

Answer 29

Transbronchial or thoracoscopic

Question 30

Which diseases feature chronic interstitial disease?

Answer 30

Fibrosing alveolitis
Sarcoidosis
EEA
Pneumoconiosis

Question 31

What happens to the terminal lung in fibrosing alveolitis?

Answer 31

Lung structure is replaced by dilated space surrounded by fibrous walls

Question 32

What effects can connective tissue disease have on the lungs?

Answer 32

Interstitial fibrosis
Pleural effusions
Rheumatoid nodules

Question 33

What is pneumoconiosis?

Answer 33

Lung disease caused by mineral dust

Question 34

Which type of asbestos is relatively safe?

Answer 34

Serpentine - curved

Question 35

Which type of asbestos is highly dangerous?

Answer 35

Amphibole - straight

Question 36

What does asbestos in the lungs cause?

Answer 36

Parietal pleural plaques
Interstitial fibrosis
Bronchial carcinoma
Mesothelioma