restrictive lung disease-clinical features Flashcards
what is the physiological definition of restrictive lung disease?
FVC <80% of the predicted normal
what do obstructive lung diseases do to residual volume?
they increase it significantly
how does restrictive lung disease affect residual volume?
it reduces it
how does restrictive lung disease affect inspiratory reserve volume?
it causes it to reduce
how does restrictive lung disease affect expiratory reserve volume?
it reduces it
what are pleural causes of restrictive lung disease?
pleural effusion
pneumothorax
pleural thickening
how can a pleural effusion be a restrictive lung disease?
the fluid on the outside of the lung can compress the lung
how can a pneumothorax be a restrictive lung disease
the air in the pleural space can compress the lung or just cause it to collapse
what is the most common cause of pleural thickening?
asbestos exposure
how can pleural thickening be a restrictive lung disease?
the thickened pleura will be less able to stretch so will restrict lung expansion.
what are some skeletal causes of restrictive lung disease?
kyphoscoliosis
ankylosing spondylitis
thoracoplasty
rib fractures
how can kyphoscoliosis cause restrictive lung disease?
it decreases chest expansion
how can ankylosing spondylitis cause restrictive lung disease?
it will decrease chest expansion
what is thoracoplasty?
a procedure performed on TB patients in the past to produce anaerobic conditions in an attempt to kill off the bacteria
how can thoracoplasty be a restrictive?
it prevents one lung from inflating
what are the musclular causes of restrictive lung disease?
amyotrophic lateral sclerosis
what are the sub-diaphragmatic causes of rextriction?
pregnancy
obesity
what are the three most important interstitial lung diseases?
sarcoidosis
idiopathic pulmonary fibrosis
hypersensitivity pneumonitis
what is sarcoidosis?
multisystem granulomatous disease of unknown cause
what are the symptoms of sarcoidosis?
erythema nodosum
uveitis
who does sarcoidosis affect?
adults <40
women> men
what are the investigations of sarcoidosis?
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
can sarcoidosis resolve itself?
yes, at stage 1 the remission rate is 55-90%
what happens to the remission rate as sarcoidosis moves tough the stages?
it decrease until it is 0% at stage 4
how is sarcoidosis treated if it is mild, no vital organ involvement, normal lung function and few symptoms?
not treatment
what is the treatment of sacoisosis and erythema nodosum?
NSAIDs
what is the treatment for skin lesions, anterior uveitis and cough caused by sarcoidosis?
topical steroids
what is the treatment for cardiac, neurological, eye disease (not responding to topical steroids) and hypercalcaemia?
systemic steroids
what are some of the complications of sarcoidosis?
progressive respiratory failure
bronchiectasis
aspergilloma, haemoptysis, pmeumothorax
what are the symptoms and signs of idiopathic pulonary fibrosis?
chronis brethlessness and cough
clubbing
crackles in chest
no response to LVF or infection
what are the medical options for idiopathic pulmonary fibrosis?
oral antifibrotics- pirfenidone, nintedanib, palliative care
surgical option- transplantation
