Restrictive Lung Disease Flashcards
Where do restrictive lung diseases target?
Interstitum of Lung - Connective tissue space around airways and vessels. Space between basement membranes of alveolar walls.
How does interstitial lung disease present?
Abnormal CXR
Dyspnoea - first on exertion then progresses to rest
Type 1 respiratory failure
Heart failure.
Give an example of an acute presentation of ILD?
Diffuse Alveolar Damage
What are some associations of Diffuse Alveolar Damage?
Major trauma Chemical injury / toxic inhalation Circulatory shock Drugs Infection Auto(immune) disease Radiation Idiopathic.
How does DAD present?
Dyspnoea, cough, fever
What are the histological features of DADs?
Exudative phase - Protein rich alveolar and interstitial oedema and hyaline membranes.
Proliferative phase - Epithelial proliferation, Fibroblast proliferation and type 2 pneumocyte proliferation. Fibrosis of interstitum. Scarring Stiff hard lungs. Patchy opacities.
What is sarcoidosis?
A multisystem granulomatous disorder of unknown aetiology. Chronic restrictive lung disease.
How does sarcoidosis present?
Acute arthralgia (joint pain) Erythema nodosum - swollen fat under skin causing red lumps and patches. Bilateral hilar lymphadenopathy - enlargement of lymph nodes of pulmonary hila.
What are the histological presentations of sarcoidosis?
Epithelioid and giant cell granulomas Non necrotising Little lymphoid infiltrate Variable associated fibrosis Granulomas form in bones which increases serum calcium
What is hypersensitivity pneumonitis?
Inflammation of alveoli due to the hypersensitivity caused by inhaled organic dusts.
What are the antigens of hypersensitivity pneumonitis?
Thermophilic actinomycetes:(gram positive)
Micropolyspora faeni
Thermoactinomyces vulgaris.
Bird / Animal proteins - faeces, bloom
Fungi - Aspergillus spp
Chemicals
How does hypersensitivity pneumonitis present?
Acute - Fever, dry cough, myalgia,
Chills 4-9 hours after Ag exposure
Crackles, tachyopnoea, wheeze
Precipitating antibody
Chronic- Insidious
Malaise, SOB(short of breath), cough
Low grade illness
Crackles and some wheeze
