Restrictive lung diseases Flashcards
lung restriction is defined as
TLC< 80%
Causes of lung restriction
ILD
chest wall restriction
Neuromuscular disease
on xray ILD can present as
reticulations
nodularity
what are the PFT findings of restrictive lung disease - 4 main findings
TLC goes down
FEV1 FVC go down proportionally
low diffusing capacity
hypoxemia
Small lung (TLC low) with low Diffusing capacity then you’re thinking
ILD - parenchymal
3 causes of a low TLC (restrictive) but normal DLCO
- Obesity
- pleural disease
- bony abnormality
how do you distinguish a muscle problem from chest wall problem?
need measure muscle strength -
patients will have a smaller FVC when supine
what can indicate muscle weakness
A drop in fvc > 20% when supine
Upper lobe disease - ILD
FASST
hypersensitivity pneumonitis is a
TYPE 3-4 hypersensitivity reaction
NOT type 1
Farmers lung caused by
thermophilic actinomyces
tobaco grower’s lungs
aspergillus
hot tub lung
mycobacterium avium
chemicals used to make foams and butter flavored popcorn
isocyanates
diacetyl
what are PFTs like in ILD HP- hypersensitivity pneumonitis?
low DLCO - but can have a restrictive, obstructive pattern
ILD with Upperlobe findings, fibrosis
nodules more than reticular, Calcified nodes
Silicosis
incidental finding of bilateral hilar adenopathy
asymptomatic
findings of ILD
Upper lobe abnormalities - mostly nodular
sarcoidosis
Stage of sarcoidosis if
Bilateral hilar adenopathy
asymptomatic
Stage 1
Stage of sarcoidosis if Bilateral hilar adenopathy AND upper lobe nodules some symptoms
Stage 2
Stage of sarcoidosis if firbosis AND upper lobe nodules NO adenopathy with symptoms
Stage 3
Bilateral hilar adenopathy
Fever
migratory polyarthralgias
erythema nodosum
Loffgren’s syndrome - WILL RESOLVE
patients with sarcoidosis can present with
skin lesions
uveitis
stones
hypercalcemia
stage 3 and 4 sarcoidosis treat with
prednisone
lower lobe interstitial lung disease
RAAIDS
which drugs can cause LLLD
- amiodoraone
nitrofurantoin
Connective tissue disease - ILD
scleroderma or RA
sarcoid is most common in what years
IPF most common
< 50
> 50
IPF years survival after diagnosis
3-5
diagnosis of IPF - usual interstitial pneumonia pattern on CT!!!!
r/o other ILD
- RETICULATION is predominant abnormality
- Honeycombing
What do you NOT use for treatment of IPF
Prednisone and immunosupp therapy
INCREASE mortality
use anti-fibrotic agents
