Restrictive Lung Disease Flashcards

1
Q

Give another name for restrictive lung disease

A

Interstitial lung disease

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2
Q

What is the underlying pathology?

A

Inflammation and fibrosis causes thickening and excess cells to occupy the interstitium between the capillaries and the alveolar walls.

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3
Q

How does this impact on lung function?

A

It creates a barrier to gas exchange, affecting oxygen transfer more than CO2.
Also means the lungs are less compliant due to the build up of collagen.

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4
Q

How does this appear in spirometry?

A

FEV1/FVC will be reduced but in the same ratio- just less air going in.

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5
Q

What is a classic presentation of RLD?

A

Breathlessness on exertion
abnormal CXR
Type 1 respiratory failure.

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6
Q

Name three causes of Chronic RLD

A

Granulomatous- sarcoidosis
UIP- usual interstitial pneumonitis/ idiopathic pulmonary fibrosis.
Smoking/ COP

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7
Q

What is sarcoidosis?

A

Multi-system disease causes granulomatous deposits throughout the body.
Cells are non-necrosing (not TB)

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8
Q

What are the most common sites of Granulomas in Sarcoidosis?

A

Lungs and Lymph nodes

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9
Q

Signs and Symptoms of Sarcoidosis

A
Arthralgia (sore knees) 
Erythema Nodosum (rash/lesions
Bilateral Hilar Lymphadenopathy
SOB
Cough
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10
Q

Investigations for sarcoidosis

A
Radiology - CXR abnormal = poorer prognosis
Serum Ca
PFT
FBC
ECG
Urine
TB skin tests
Eye exam 
Biopsy
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11
Q

Name another chronic restrictive lung condition

A

Hypersensitivity Pneumonitis

allergic alveolitis

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12
Q

Common causes of HP

A
  • Pigeon (bloom from feather)
  • Hay (mould spores)
  • Fungi (aspergillus)
  • cause allergic reaction in the lungs leading to granuloma formation.
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13
Q

Signs and symptoms of HP

A

Can be acute or chronic

Acute- mimics infections

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14
Q

S & S Acute HP

A
  • Cough (dry)
  • Fever
  • Precipitating Antibody
  • Crackles, wheeze
  • Tachypnoea
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15
Q

S & S CHRONIC

A
  • low grade illness
  • cough
  • Malaise
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16
Q

Investigations

A

CXR

17
Q

Which type of reaction is this?

A

Type III & IV

  • Small soft granulomas
  • Lymphocytes
  • ongoing inflammation
18
Q

Describe UIP

A

Causes patchy interstitial lung inflammation due to mostly unknown causes.

19
Q

Describe the pathophysiology of UIP

A
  • Patchy inflammation
  • Type II pneumocyte hyperplasia
  • pattern of ongoing inflammation and scarring
  • Fibroblastic foci- produce collagen
  • smooth muscle and vascular proliferation.
20
Q

Signs of UIP

A
  • Dyspnoea
  • Cough
  • Basal crackles
  • Cyanosis
  • Clubbing
  • reduced pulmonary function.
21
Q

Investigations for UIP

A

CXR
see all stages- inflammation to fibrosis
basal and posteriorly

22
Q

Treatment of Sarcoidosis

A
  • NSAIDS
  • Topical Steroids
  • Systemic Steroids (if CVD, Neuro or eye disease)
23
Q

Treatment of UIP

A

OAF- oral anti fibrotics.