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Respiratory > Restrictive lung disease > Flashcards

Restrictive lung disease Flashcards

1
Q

d:intrinsic lung disease

A

disease of the lung itself

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2
Q

d: extrinsic lung disease

A

Thoracic/extra-thoracic
neuro-muscular
pleural diseases

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3
Q

consequences of intrinsic lung diseases

A 
Restrict normal lung function;
 impaired gas exchange
varying degrees of inflammation
fibrous scar tissue
Alveolar: inflammation 
Oedema; haemorrhage (vasculitides); infection
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4
Q

Name the 4 categories in interstitial lung disease

A

drug related/ association

Idiopathic
Interstitial
Pneumonia (IIP)

Granulomatous
ILDs eg
Sarcoidosis, EAA

other eg LAM, HX

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5
Q

d: idiopathic

A

relating to or denoting any disease or condition which arises spontaneously or for which the cause is unknown

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6
Q

describe the flow volume curve for a restrictive lung disease

A

same height so normal shape
normal PF
reduced volume

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7
Q

Describe what LFTs would show for a restrictive lung disease?

A

Restrictive pattern
↓Forced Vital Capacity (FVC) with FEV1/FVC >70
↓DLCO (<80% predicted)

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8
Q

disease of alveolar walls/lumen is extrinsic/intrinsic?

A

intrinsic

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9
Q

describe the pathophysiology of alveolar disease?

A 
impaired alveolar gas exchange
alveolar barrier to O2 exchange
Alveolar-Arteriolar barrier (A-a gradient)
CO2 exchange unimpaired
alveolar ventilation normal  
CO2 very soluble and blown off
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10
Q

What happens to the PaO2, SaO2 and PaCO2 in alveolar disease

A

decreased
decreased
normal

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11
Q

d: DLCO

A

Diffusion capacity of carbon monoxide (DLCO)

- measures gas diffusion across alveolar-arteriolar barrier

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12
Q

d: single breath diffusing capacity

A

CO diffusion across alveolar-capillary barrier

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13
Q

if the DLCO is decreased, what diseases may it be?

A

Anaemia, Emphysema, ILDs, Pulmonary oedema, PE, pulmonary hypertension

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14
Q

why is DLCO used to monitor treatment in ILD?

A

more sensitive than FVC

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15
Q

egs of thoracic/ Xtra thoracic related disease

A

obesity; kyphoscoliosis; ascites; diaphragmatic palsy

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16
Q

d: kyphoscoliosis

A

describes an abnormal curvature of the spine in both a coronal and sagittal plane

17
Q

d:ascites

A

abnormal build up of fluid in the abdomen

18
Q

egs of neuro-muscular disorders

A

motor neuron disease

myasthenia gravis

19
Q

d: myasthenia gravis

A

long-term neuromuscular disease that leads to varying degrees of skeletal muscle weakness The most commonly affected muscles are those of the eyes, face, and swallowing

20
Q

egs pleural disease in extrinsic ILD

A

pleural thickening
mesothelioma
large Pleural Effusions

21
Q

describe the pathophysiology of restrictive hypoventilation

  • thoracic/extra-thoracic
  • neuromuscular
A

Hypoventilation means impaired alveolar ventilation which means a rise in paCO2 and reduced paO2
ALVEOLAR GAS EQUATION
Obesity / kyphoscoliosis reduce chest wall compliance
Neuromuscular conditions reduced power of muscles involved in respiration

22
Q

d: minute ventilation

A

breaths/min X tidal volume

23
Q

what can an obese patient that can increase ventilatory drive and minute ventilation get?

A

simple obesity

obstructive sleep apnoea

24
Q

what can an obese patient that cannot increase ventilatory drive and minute ventilation get

A

hypoventilation especially during sleep
-hypercapnia and hypoxemia
leads to OSA and obesity hypoventilation syndrome

25
Q

symptoms of restrictive thoracic disease

A

Breathless on exertion

  • Cough but no wheeze
  • Finger clubbing
  • Inspiratory Lung Crackles
  • Central Cyanosis (if hypoxaemic)
  • Pulmonary fibrosis can occur as end stage response to chronic inflammation
26
Q

what is CO2 retention a sign of?

A

type 2 respiratory failure

27
Q

what would ABGs of restrictive lung disease show?

A 
Type I (paO2 <8kPa) or Type II respiratory failure (hypoxia with hypercapnia - pCO2>6 kPA) 
↑ bicarb. = chronic hypercapnia
28
Q

name some treatments of restrictive lung diseases

A 
weight loss
remove any trigger factor
medical therapy
procedures: intercostal drainage or ascetic drainage
surgery: corrective spinal surgery
lung transplant etc
29
Q

name 3 supportive treatments

A

CPAP
non-invasive ventilation (NIV)
Oxygen

30
Q

d: CPAP

A

CPAP is a treatment that uses mild air pressure to keep your breathing airways open. It involves using a CPAP machine

Respiratory (27 decks)

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