Restrictive Lung Disease Flashcards
What are the PLEURAL CAUSES of restrictive lung disease?
1) Pleural Effusion
2) Pneumothorax
3) Pleural Thickening
What are the SKELETAL CAUSES of restrictive lung disease?
1) Kyphoscoliosis
2) Ankylosing Spondylitis
3) Thoracoplasty
4) Rib Fractures
What are the MUSCULAR CAUSES of restrictive lung disease?
Amyotrophic Lateral Sclerosis (ALS)
What are the SUB-DIAPHRAGMATIC CAUSES of restrictive lung disease?
1) Obesity
2) Pregnancy
What is the PHYSIOLOGICAL DEFINITION of a restrictive lung disease?
Forced Vital Capacity < 80% of the predicted normal
What are the CLINICAL FEATURES associated with restrictive lung disease?
1) < Lung Compliance (stiff lungs)
2) Low FEV1 and FVC (Normal/High FEV1/FVC ratio)
3) < Gas Transfer
4) V/Q Mismatch
5) Abnormal CXR
6) Dyspnoea - on Exertion and then at Rest
7) Type I Respiratory Failure
8) Cardiac Failure
What are the SIGNS of Sarcoidosis?
1) Erythema Nodosum (lower limbs)
2) Acute Arthralgia
3) Anterior Uveitis
4) Lupus Pernio
5) Bilateral Hilar Lymphadenopathy (CXR)
What INVESTIGATIONS would you use to diagnose Sarcoidosis?
1) History-taking and Clinical Examination
2) CXR
3) Pulmonary Function Tests
4) Bloods/ Serum Ca2+ and ACE
5) Urinalysis
6) ECG
7) TB Skin Test
8) Eye Exam
What FURTHER INVESTIGATIONS could be used for Sarcoidosis?
1) Bronchoscopy - Transbronchial Biopsy and Endobronchial Ultrasound
2) High Resolution CT
3) Mediastinoscopy
4) Video Assisted Thoracoscopic Lung Biopsy (VATS)
What TREATMENT(S) would be used for symptoms of Erythema Nodosum and Arthralgia?
Non-steroidal anti-inflammatories (NSAIDS)
What TREATMENT(S) would be used for symptoms of Lupus Pernio, Anterior Uveitis and Cough?
Topical Steroids
What is SARCOIDOSIS?
Multisystem Granulomatous Disease of Unknown Aetiology
What is the MAIN HISTOPATHOLOGICAL characteristic of Sarcoidosis?
Non-Caseating Granulomatous Formation
What are the potential CAUSES of DIFFUSE ALVEOLAR DAMAGE (DADS)?
Idiopathic Major Trauma Chemical Injury Circulatory Shock Drug Toxicity Infection Autoimmune Disease Radiation
What are the MAIN HISTOPATHOLOGICAL characteristics of USUAL INTERSTITIAL PNEUMONITIS (UIP)?
1) Patchy Interstitial Chronic Inflammation
2) Type II Pneumocyte Hyperplasia
3) Smooth Muscle and Vascular Proliferation
What are some of the CAUSES of UIP?
1) Idiopathic
2) Connective Tissue Disease, i.e. Rheumatoid Disease
3) Drug Reaction
4) Post Infection
5) Industrial Exposure, i.e. Asbestos
What are the SIGNS of UIP?
Basal Crackles
Cyanosis
Finger Clubbing
What are the SYMPTOMS of UIP?
Dyspnoea
Cough
What are the CLINICAL FEATURES of UIP?
1) Restrictive PFT Pattern, i.e. Low FEV1 and Low FVC
2) < Gas Transfer
3) Imaging - Basal/Posterior Fibrosis with Honeycombing
What are the TREATMENT OPTIONS for UIP?
Poor Prognosis
1) Oral Anti-Fibrotics, i.e. Pirfenidone
2) Transplantation
3) Palliative Care
What is the SIGNIFICANCE of ‘HONEYCOMBING’ of the lung?
Irreversible Stage of Pulmonary Fibrosis
Fibrotic Cystic changes seen in End-Stage Interstitial Lung Disease
What are some of the defining characteristics of HYPERSENSITIVITY PNEUMONITIS (HP)?
1) Allergic Alveolitis Mediated by Type III and IV Hypersensitivity Reactions
2) Soft Centriacinar Epithelioid Granulomata
3) Upper Zone Disease
What are some of the CAUSES of HP?
Macromolecules of Inhaled Antigens
1) Animal Faeces
2) Spore-Forming Bacteria
3) Fungi, i.e. Aspergillus
4) Chemicals
What are some of the ACUTE SYMPTOMS of HP?
Fever
Dry Cough
Myalgia
