Restrictive Lung Disease Flashcards
Give another name for restrictive lung disease
Interstitial lung disease
What is the underlying pathology?
Inflammation and fibrosis causes thickening and excess cells to occupy the interstitium between the capillaries and the alveolar walls.
How does this impact on lung function?
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.
How does this appear in spirometry?
FEV1/FVC will be reduced but in the same ratio- just less air going in.
What is a classic presentation of RLD?
Breathlessness on exertion
abnormal CXR
Type 1 respiratory failure.
Name three causes of Chronic RLD
Granulomatous- sarcoidosis
UIP- usual interstitial pneumonitis/ idiopathic pulmonary fibrosis.
Smoking/ COP
What is sarcoidosis?
Multi-system disease causes granulomatous deposits throughout the body.
Cells are non-necrosing (not TB)
What are the most common sites of Granulomas in Sarcoidosis?
Lungs and Lymph nodes
Signs and Symptoms of Sarcoidosis
Arthralgia (sore knees) Erythema Nodosum (rash/lesions Bilateral Hilar Lymphadenopathy SOB Cough
Investigations for sarcoidosis
Radiology - CXR abnormal = poorer prognosis Serum Ca PFT FBC ECG Urine TB skin tests Eye exam Biopsy
Name another chronic restrictive lung condition
Hypersensitivity Pneumonitis
allergic alveolitis
Common causes of HP
- Pigeon (bloom from feather)
- Hay (mould spores)
- Fungi (aspergillus)
- cause allergic reaction in the lungs leading to granuloma formation.
Signs and symptoms of HP
Can be acute or chronic
Acute- mimics infections
S & S Acute HP
- Cough (dry)
- Fever
- Precipitating Antibody
- Crackles, wheeze
- Tachypnoea
S & S CHRONIC
- low grade illness
- cough
- Malaise
Investigations
CXR
Which type of reaction is this?
Type III & IV
- Small soft granulomas
- Lymphocytes
- ongoing inflammation
Describe UIP
Causes patchy interstitial lung inflammation due to mostly unknown causes.
Describe the pathophysiology of UIP
- Patchy inflammation
- Type II pneumocyte hyperplasia
- pattern of ongoing inflammation and scarring
- Fibroblastic foci- produce collagen
- smooth muscle and vascular proliferation.
Signs of UIP
- Dyspnoea
- Cough
- Basal crackles
- Cyanosis
- Clubbing
- reduced pulmonary function.
Investigations for UIP
CXR
see all stages- inflammation to fibrosis
basal and posteriorly
Treatment of Sarcoidosis
- NSAIDS
- Topical Steroids
- Systemic Steroids (if CVD, Neuro or eye disease)
Treatment of UIP
OAF- oral anti fibrotics.
