Restrictive Lung Diseases

Question 1

Which structure(s) are mainly damaged in interstitial lung disease?

Answer 1

Alveolar walls and lumen

Causes impaired gas exchange

Question 2

CO2 and O2 exchange is impaired. True/False?

Answer 2

False

CO2 exchange is unimpaired as it is very soluble

Question 3

How can consolidation of alveolar spaces arise?

Answer 3

Infection (pneumonia)
Infarction (PE)
BOOP (none of above)

Question 4

What is sarcoidosis?

Answer 4

Non-caseating granulomatous disease (Type IV hypersensitivity) of unknown aetiology

Question 5

Sarcoidosis is less common in smokers. True/False?

Answer 5

True!

Question 6

List some clinical signs of sarcoidosis

Answer 6

Erythema nodosum
Bilateral hilar lymphadenopathy
Arthritis
Fever
Lung infiltrates
Multi-system damage

Question 7

Is treatment given for sarcoidosis?

Answer 7

Oral steroids and immunosuppressives ONLY IF vital organs are being affected/chronic

Question 8

Symptoms of EAA occur rapidly. True/False?

Answer 8

False

Typically several hours after exposure

Question 9

How is EAA treated?

Answer 9

Antigen avoidance

Oral steroids if very breathless

Question 10

What is the most common ILD?

Answer 10

Idiopathic pulmonary fibrosis

Question 11

What is the proposed aetiology of idiopathic PF?

Answer 11

Imbalance in fibrotic repair, resulting in scarring of the lung

Question 12

Name some drugs which can cause IPF

Answer 12

Amiodarone, Methotrexate, Cyclophosphamide, Nitrofurantoin

Question 13

List some clinical signs of IPF

Answer 13

Progressive breathlessness
Clubbing
Bilateral fine inspiratory crackles

Question 14

What is pneumoconiosis?

Answer 14

ILD caused by inhalation of occupational dusts

Question 15

Describe the early and late stages of ILD

Answer 15

Early: alveolitis (inflammatory infiltrates)
Late: scarring

Question 16

Lung tissue becomes fibrous in IPF. What is the physiological consequence of this?

Answer 16

Reduced compliance (not as elastic)

Question 17

Define asbestosis

Answer 17

Fibrosis due to asbestos exposure

Question 18

IPF is commoner in females. True/False?

Answer 18

False

Commoner in males

Question 19

What is heard on auscultation in IPF?

Answer 19

Fine bilateral end-inspiratory crackles

Question 20

What is extrinsic allergic alveolitis?

Answer 20

Inflammation in airways due inhalation of foreign antigens, usually from animals

Question 21

Smokers have increased risk of EAA. True/False?

Answer 21

False

Decreased risk!

Question 22

What is heard on auscultation in EAA?

Answer 22

Coarse end-inspiratory crackles