Restrictive Lung Disease Flashcards
what is a common exposure for small airways disease?
smoke pits…tour in afghanistan
what does small airways disease…obstructive or restrictive airway disease?
obstructive…anything with the airways is always obstructive
name three ways to effect the chest wall and restrict it
mordib obesity
kyphoscoliosis
fibrothorax
name four things that cause weakness of respiratory muscles
polia
myasthenia gravis
guillian baree
amyotrophic lateral sclerosis (ALS)
name two things that cause abnormalities of lung parenchyma
sarcoidosis
idiopathic pulmonary fibrosis
how does ILD affect TLC, FRC and RV?
they are all decreased
how does muscle weakness affect TLC, FRC and RV?
TLC decreased FRC normal and RV increased
how does obesity affect TLC, FRC, and RV?
TLC slightly reduced or normal
FRC REDUCED
RV normal
what is the tip off lung volume change for obesity?
reduced FRC
what is another name for interstitial lung disease?
diffuse parnehcymal Lung disease
in restrictive disease…does compliance increase of decrease?
decreased!!
how does ILD affect the FVC?
it lowers it
how does ratio of FEV1/FVC change in ILD?
it will be normal or high
how does ILD affect DLCO?
it takes longer for the oxygen to diffuse..so DLCO is decreased compared to normal
what are two common signs of cor pulmonale?
jugular venous distension
peripheral edema
what is the most common disease that mimics ILD?
congestive heart failure
is silicosis an upper or lower lobe disease?
upper lobe
what does silicosis cause?
calcification in the upper love
is asbestosis an upper or lower lobe lung disease?
lower lobe disease
what is a histological finding in asbestosis?
ferruganous bodies, iron deposits
is coal worker pneumoconiosis an upper or lower lobe disease?
upper lobe
what is the gold standard imaging for ILD?
high resolution CT
what does ground glass on a CT suggest in ILD?
active inflammation
what CT finding does diffuse alveolar hemorrhage?
ground glass…due to bloody
is IPF in lower or upper lobes?
lower lobes..
what ILD does clubbing signal?
IPF
explain the disease mechanism in IPF
injury to epithelium causes cytokine release that activates myofibroblasts instead of epithelial recovery..leads to collagen deposition
what does it mean for granuloma to be non caseating?
no necrotizing in the middle of the granuloma
what cells make up the granuloma in sarcoid?
macrophages, histiocytes, lymphocytes and dendritic cells
what cytokines are associated with sarcoidosis? what T cell?
IFN-gamma
IL2
IL12
Th1
is sarcoidosis caused by antigens or nah?
questionable…maybe non TB myco in US
after development of granulomas in saroidosis…what can happen to them?
can either self resolve or progress to fibrotic tissue
is sarcoidosis an upper or lower lobe disease?
upper lobe
how to diagnose sarcoidosis?
bronchoscopy…must have proof of granulomas
what two things must you see to diagnose Sarcoid?
granulomas
no evidence of cancer, infection with TB or fungus
what are cutaneous granulomas called in sarcoid?
lupus pernio
name a kidney finding with sarcoidosis?
hypercalcemia leading to nodules in the kidney
what molecule leads to hypercalcemia in sarcoid?
alpha 1 hydroxylase
name three common causes of diffuse alveolar hemorrhage
goodpasture syndrome
microscopic polyangitis
granulomatous with polyangitis
what two molecules associated with kidneys are elevated in sarcoidosis?
ACE and Calcium
what are the four stages of sarcoidosis?
1-lymphadenopathy hilar
2/3- lung parenchyma involvement
4- fibrosis
what is the treatment for sarcoidosis? when should it be initiated?
corticosteroids when symptomatic
