restrictive lung disease-clinical features Flashcards

1
Q

what is the physiological definition of restrictive lung disease?

A

FVC <80% of the predicted normal

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2
Q

what do obstructive lung diseases do to residual volume?

A

they increase it significantly

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3
Q

how does restrictive lung disease affect residual volume?

A

it reduces it

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4
Q

how does restrictive lung disease affect inspiratory reserve volume?

A

it causes it to reduce

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5
Q

how does restrictive lung disease affect expiratory reserve volume?

A

it reduces it

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6
Q

what are pleural causes of restrictive lung disease?

A

pleural effusion
pneumothorax
pleural thickening

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7
Q

how can a pleural effusion be a restrictive lung disease?

A

the fluid on the outside of the lung can compress the lung

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8
Q

how can a pneumothorax be a restrictive lung disease

A

the air in the pleural space can compress the lung or just cause it to collapse

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9
Q

what is the most common cause of pleural thickening?

A

asbestos exposure

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10
Q

how can pleural thickening be a restrictive lung disease?

A

the thickened pleura will be less able to stretch so will restrict lung expansion.

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11
Q

what are some skeletal causes of restrictive lung disease?

A

kyphoscoliosis
ankylosing spondylitis
thoracoplasty
rib fractures

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12
Q

how can kyphoscoliosis cause restrictive lung disease?

A

it decreases chest expansion

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13
Q

how can ankylosing spondylitis cause restrictive lung disease?

A

it will decrease chest expansion

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14
Q

what is thoracoplasty?

A

a procedure performed on TB patients in the past to produce anaerobic conditions in an attempt to kill off the bacteria

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15
Q

how can thoracoplasty be a restrictive?

A

it prevents one lung from inflating

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16
Q

what are the musclular causes of restrictive lung disease?

A

amyotrophic lateral sclerosis

17
Q

what are the sub-diaphragmatic causes of rextriction?

A

pregnancy

obesity

18
Q

what are the three most important interstitial lung diseases?

A

sarcoidosis
idiopathic pulmonary fibrosis
hypersensitivity pneumonitis

19
Q

what is sarcoidosis?

A

multisystem granulomatous disease of unknown cause

20
Q

what are the symptoms of sarcoidosis?

A

erythema nodosum

uveitis

21
Q

who does sarcoidosis affect?

A

adults <40

women> men

22
Q

what are the investigations of sarcoidosis?

A
history and examination
CXR
pulmonary function tests
bloods
urinalysis
ECG
TB skin test
eye exam
bronchoscopy including transbronchial biopsies and endobronchial ultrasound
madiastinoscopy
video assisted thoracoscopic lung biopsy
23
Q

can sarcoidosis resolve itself?

A

yes, at stage 1 the remission rate is 55-90%

24
Q

what happens to the remission rate as sarcoidosis moves tough the stages?

A

it decrease until it is 0% at stage 4

25
Q

how is sarcoidosis treated if it is mild, no vital organ involvement, normal lung function and few symptoms?

A

not treatment

26
Q

what is the treatment of sacoisosis and erythema nodosum?

A

NSAIDs

27
Q

what is the treatment for skin lesions, anterior uveitis and cough caused by sarcoidosis?

A

topical steroids

28
Q

what is the treatment for cardiac, neurological, eye disease (not responding to topical steroids) and hypercalcaemia?

A

systemic steroids

29
Q

what are some of the complications of sarcoidosis?

A

progressive respiratory failure
bronchiectasis
aspergilloma, haemoptysis, pmeumothorax

30
Q

what are the symptoms and signs of idiopathic pulonary fibrosis?

A

chronis brethlessness and cough
clubbing
crackles in chest
no response to LVF or infection

31
Q

what are the medical options for idiopathic pulmonary fibrosis?

A

oral antifibrotics- pirfenidone, nintedanib, palliative care

surgical option- transplantation