Restrictive lung diseases

Question 1

lung restriction is defined as

Answer 1

TLC< 80%

Question 2

Causes of lung restriction

Answer 2

ILD
chest wall restriction
Neuromuscular disease

Question 3

on xray ILD can present as

Answer 3

reticulations

nodularity

Question 4

what are the PFT findings of restrictive lung disease - 4 main findings

Answer 4

TLC goes down
FEV1 FVC go down proportionally
low diffusing capacity
hypoxemia

Question 5

Small lung (TLC low) with low Diffusing capacity then you’re thinking

Answer 5

ILD - parenchymal

Question 6

3 causes of a low TLC (restrictive) but normal DLCO

Answer 6

• Obesity
• pleural disease
• bony abnormality

Question 7

how do you distinguish a muscle problem from chest wall problem?

Answer 7

need measure muscle strength -

patients will have a smaller FVC when supine

Question 8

what can indicate muscle weakness

Answer 8

A drop in fvc > 20% when supine

Question 9

Upper lobe disease - ILD

Answer 9

FASST

Question 10

hypersensitivity pneumonitis is a

Answer 10

TYPE 3-4 hypersensitivity reaction

NOT type 1

Question 11

Farmers lung caused by

Answer 11

thermophilic actinomyces

Question 12

tobaco grower’s lungs

Answer 12

aspergillus

Question 13

hot tub lung

Answer 13

mycobacterium avium

Question 14

chemicals used to make foams and butter flavored popcorn

Answer 14

isocyanates

diacetyl

Question 15

what are PFTs like in ILD HP- hypersensitivity pneumonitis?

Answer 15

low DLCO - but can have a restrictive, obstructive pattern

Question 16

ILD with Upperlobe findings, fibrosis

nodules more than reticular, Calcified nodes

Answer 16

Silicosis

Question 17

incidental finding of bilateral hilar adenopathy
asymptomatic
findings of ILD
Upper lobe abnormalities - mostly nodular

Answer 17

sarcoidosis

Question 18

Stage of sarcoidosis if
Bilateral hilar adenopathy
asymptomatic

Answer 18

Stage 1

Question 19

Stage of sarcoidosis if 
Bilateral hilar adenopathy 
AND
upper lobe nodules 
some symptoms

Answer 19

Stage 2

Question 20

Stage of sarcoidosis if 
firbosis 
AND
upper lobe nodules 
NO adenopathy 
with symptoms

Answer 20

Stage 3

Question 21

Bilateral hilar adenopathy
Fever
migratory polyarthralgias
erythema nodosum

Answer 21

Loffgren’s syndrome - WILL RESOLVE

Question 22

patients with sarcoidosis can present with

Answer 22

skin lesions
uveitis
stones
hypercalcemia

Question 23

stage 3 and 4 sarcoidosis treat with

Answer 23

prednisone

Question 24

lower lobe interstitial lung disease

Answer 24

RAAIDS

Question 25

which drugs can cause LLLD

Answer 25

• amiodoraone

nitrofurantoin

Question 26

Connective tissue disease - ILD

Answer 26

scleroderma or RA

Question 27

sarcoid is most common in what years

IPF most common

Answer 27

< 50

> 50

Question 28

IPF years survival after diagnosis

Answer 28

3-5

Question 29

diagnosis of IPF - usual interstitial pneumonia pattern on CT!!!!

Answer 29

r/o other ILD

• RETICULATION is predominant abnormality
• Honeycombing

Question 30

What do you NOT use for treatment of IPF

Answer 30

Prednisone and immunosupp therapy
INCREASE mortality
use anti-fibrotic agents