Restrictive Lung Disease Flashcards

1
Q

What are the PLEURAL CAUSES of restrictive lung disease?

A

1) Pleural Effusion
2) Pneumothorax
3) Pleural Thickening

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2
Q

What are the SKELETAL CAUSES of restrictive lung disease?

A

1) Kyphoscoliosis
2) Ankylosing Spondylitis
3) Thoracoplasty
4) Rib Fractures

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3
Q

What are the MUSCULAR CAUSES of restrictive lung disease?

A

Amyotrophic Lateral Sclerosis (ALS)

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4
Q

What are the SUB-DIAPHRAGMATIC CAUSES of restrictive lung disease?

A

1) Obesity

2) Pregnancy

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5
Q

What is the PHYSIOLOGICAL DEFINITION of a restrictive lung disease?

A

Forced Vital Capacity < 80% of the predicted normal

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6
Q

What are the CLINICAL FEATURES associated with restrictive lung disease?

A

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

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7
Q

What are the SIGNS of Sarcoidosis?

A

1) Erythema Nodosum (lower limbs)
2) Acute Arthralgia
3) Anterior Uveitis
4) Lupus Pernio
5) Bilateral Hilar Lymphadenopathy (CXR)

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8
Q

What INVESTIGATIONS would you use to diagnose Sarcoidosis?

A

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

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9
Q

What FURTHER INVESTIGATIONS could be used for Sarcoidosis?

A

1) Bronchoscopy - Transbronchial Biopsy and Endobronchial Ultrasound
2) High Resolution CT
3) Mediastinoscopy
4) Video Assisted Thoracoscopic Lung Biopsy (VATS)

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10
Q

What TREATMENT(S) would be used for symptoms of Erythema Nodosum and Arthralgia?

A

Non-steroidal anti-inflammatories (NSAIDS)

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11
Q

What TREATMENT(S) would be used for symptoms of Lupus Pernio, Anterior Uveitis and Cough?

A

Topical Steroids

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12
Q

What is SARCOIDOSIS?

A

Multisystem Granulomatous Disease of Unknown Aetiology

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13
Q

What is the MAIN HISTOPATHOLOGICAL characteristic of Sarcoidosis?

A

Non-Caseating Granulomatous Formation

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14
Q

What are the potential CAUSES of DIFFUSE ALVEOLAR DAMAGE (DADS)?

A
Idiopathic
Major Trauma
Chemical Injury
Circulatory Shock
Drug Toxicity
Infection
Autoimmune Disease
Radiation
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15
Q

What are the MAIN HISTOPATHOLOGICAL characteristics of USUAL INTERSTITIAL PNEUMONITIS (UIP)?

A

1) Patchy Interstitial Chronic Inflammation
2) Type II Pneumocyte Hyperplasia
3) Smooth Muscle and Vascular Proliferation

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16
Q

What are some of the CAUSES of UIP?

A

1) Idiopathic
2) Connective Tissue Disease, i.e. Rheumatoid Disease
3) Drug Reaction
4) Post Infection
5) Industrial Exposure, i.e. Asbestos

17
Q

What are the SIGNS of UIP?

A

Basal Crackles
Cyanosis
Finger Clubbing

18
Q

What are the SYMPTOMS of UIP?

A

Dyspnoea

Cough

19
Q

What are the CLINICAL FEATURES of UIP?

A

1) Restrictive PFT Pattern, i.e. Low FEV1 and Low FVC
2) < Gas Transfer
3) Imaging - Basal/Posterior Fibrosis with Honeycombing

20
Q

What are the TREATMENT OPTIONS for UIP?

A

Poor Prognosis

1) Oral Anti-Fibrotics, i.e. Pirfenidone
2) Transplantation
3) Palliative Care

21
Q

What is the SIGNIFICANCE of ‘HONEYCOMBING’ of the lung?

A

Irreversible Stage of Pulmonary Fibrosis

Fibrotic Cystic changes seen in End-Stage Interstitial Lung Disease

22
Q

What are some of the defining characteristics of HYPERSENSITIVITY PNEUMONITIS (HP)?

A

1) Allergic Alveolitis Mediated by Type III and IV Hypersensitivity Reactions
2) Soft Centriacinar Epithelioid Granulomata
3) Upper Zone Disease

23
Q

What are some of the CAUSES of HP?

A

Macromolecules of Inhaled Antigens

1) Animal Faeces
2) Spore-Forming Bacteria
3) Fungi, i.e. Aspergillus
4) Chemicals

24
Q

What are some of the ACUTE SYMPTOMS of HP?

A

Fever
Dry Cough
Myalgia

25
Q

What are some of the ACUTE SIGNS of HP?

A

Tachypnoea
Wheeze
Crackles

26
Q

What are some of the CHRONIC SYMPTOMS of HP?

A

Malaise
Dyspnoea
Cough

27
Q

What are some of the CHRONIC SIGNS of HP?

A

Crackles

Some Wheeze