Restrictive Lung Disease Clinical signs and management

Question 1

restriction

Answer 1

forced vital capacity less than 80% of normal

Question 2

reasons for restriction

Answer 2

plural effusion, pneumothorax, pleural thickening, kyphoscoliosis, ankylosing spondylitis, thoracoplasty, rib fractures, motoneuron disease, obesity, pregnancy

Question 3

sarcoidosis clinical signs

Answer 3

multisystem, can have red raised painful lesions on legs, red eyes, pink skin lesions, pink scars, common in young people and more common in women than men

Question 4

sarcoidosis investigations

Answer 4

history, examination, CXR, bronchoscopy, can do mediastinoscopy or video assisted lung biopsy but unlikely

Question 5

CXR of sarcoidosis

Answer 5

in order of severity- enlarged glands, hilar lymphadenopathy, bulgy trachea, spotty lungs, fibrosis

Question 6

prognosis of sarcoidosis

Answer 6

stage 1 55-90%, stage 2 40-70%, stage 3 10-20%, stage 4 0%

Question 7

treatment of sarcoidosis

Answer 7

mild disease- no treatment, erythema nodosum- NSAIDs, skin lesions, anterior uveitis, cough- topical steroids, life threatening- systemic steroids

Question 8

idiopathic pulmonary fibrosis clinical signs

Answer 8

chronic breathlessness and cough, typically old, commoner in men, wonder if have LVF or respiratory infection, clubbing, crackles

Question 9

CXR of idiopathic pulmonary fibrosis

Answer 9

small lungs and non specific shadowing at the base, honeycomb lungs- black airways wider than they should be (stacked gaps)

Question 10

treatment of idiopathic pulmonary fibrosis

Answer 10

oral anti fibrotic drugs- nintedanib, pirfenidone, palliative care

Question 11

hypersensitivity pneumonitis

Answer 11

history is important,

Question 12

name of rash caused by sarcoidosis

Answer 12

erythema nodosum