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Pulmonary Week 2 > Restrictive Lung Diseases > Flashcards

Restrictive Lung Diseases Flashcards

1
Q

A synonym for intrinsic restrictive lung disease is?

A

interstitial

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2
Q

How is restrictive lung disease defined?

A

less than 80% (predicted) TLC (problems inflating the lungs) via a PFT

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3
Q

How is obstructive lung disease defined?

A

FEV1/FCV less than 70%

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4
Q

What are the most and least common cells in the lungs?

A

most-macrophages
least-neutrophils

middle- lymphocytes

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5
Q

What is a normal CD4/CD8 ratio in the lungs?

A

2:1

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6
Q

What is sarcoidosis?

A

multisystem disorder of unidentified etiology characterized by non-caveating granulomas

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7
Q

What patient population is common for sarcoidosis?

A

young AA female adults (20-40 yo)

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8
Q

What happens to the size of alveoli in obstructive disease?

A

increases. EXPANDED lung disease

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9
Q

What happens to the size of conducting airways in restrictive disease?

A

decreases (or may not change) BUT expiratory velocity is increased

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10
Q

T or F. Lung volumes DECREASE in restrictive lung disease

A

T. Elastic recoil is increased

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11
Q

What is Type I restrictive disease?

A

disease involves lung (intrinsic)- ILD and lung resection

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12
Q

What is Type II restrictive disease?

A

disease involves pleura chest wall, muscles, ribs, etc. (extrinsic) and neuromuscular disorders

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13
Q

Interstitial lung disease (ILD) predominantly involve what part of the lung?

A

connective tissue of the alveolar wall (in between the epithelium and endothelium)

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14
Q

How would a person with restrictive lung disease breath?

A

short, small breaths (panting) because its too hard to inflate the lungs

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15
Q

What cases the hypoxemia of ILD (interstitial lung disease)?

A

V/Q mismatch (NOT diffusion defect because there is plenty of reserve length available)

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16
Q

What are some granulomatous causes of ILD?

A
  • Berylliosis
  • Hypersensitivity pneumonitis
  • Sarcoidosis
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17
Q

What are some Non-granulomatous causes of ILD?

A
  • asbestos, coal, silica
  • radiation
  • CIGS
  • Idiopathic Interstitial Pneumonia
  • ILD with connective tissue disease
18
Q

What are some drug causes of ILD (non-granulomatous)?

A

Bleomycin, amiodarone, nitrofurantoin

19
Q

What are some types of ILD with connective tissue disease?

A
  • Rheumatoid lung
  • Lupus lung
  • Mixed CT disease
20
Q

Symptoms of ILD?

A
  • DYSPNEA, progressive
  • dry cough
  • non-specific chest pain
  • fatigue, weight loss
21
Q

Signs of of ILD?

A
  • Tachypnea, rapid-shallow
  • VELCRO crackles
  • digital clubbing
  • Cor-pulmonale
  • Pulmonary HTN
22
Q

Why is digital clubbing seen in ILD?

A

fibrosis also occurs in the nail bed

23
Q

T or F. Expiratory airflow is normal in ILD

A

T. TLC and VC are reduced though

24
Q

Most of the diagnosis of ILD can be made by what?

A

high-resolution CT scan

25
Q

What radiological feature is characteristic of early-stage ILD?

A

ground glass appearance (can be reversed)

26
Q

What radiological feature is characteristic of mid-stage ILD?

A

reticulations and nodulations (most common)

27
Q

What radiological feature is characteristic of late-stage ILD?

A

honeycombing

28
Q

How is ILD diagnosed?

A
  • Extensive history (genetics, occupation, meds, etc.)
  • H&P (velcro crackles)
  • imaging
  • PFTS
  • BAL or lung biopsy
29
Q

What is a bronchoalveolar lavage (BAL)?

A

Using a scope to sample alveolar cell populations

30
Q

Normal distribution of cells in a BAL?

A

Macro-85%
Lymph-20%
PMNS-2%

31
Q

What is a common pleural diseases?

A

Mesothelioma (tumor compresses the lung- will present will pleural effusion)

32
Q

What is a new treatment for IPF?

A

Pirfenidone

33
Q

What is a key to early diagnosis of IPF?

A

bilateral velcro (aka fine-high pitched) crackles prominent at the lung BASE upon auscultation

34
Q

T or F. In asbestosis, crackles are present before abnormalities are detected by chest radiograph, and are thus useful for screening populations exposed to asbestos

35
Q

Are crackles ever a normal physiologic phenomenon?

A

Yes, in elderly patients BUT they typically disappear after couple breaths

36
Q

What is unique about the crackles heard in IPF?

A

they are pan-inspiratory (heard throughout the entire duration of inspiration)

37
Q

T or F. In the early stages of restrictive lung disease, there is no hypoxia at rest but desaturation occurs during exercise

38
Q

PFTs of RLD?

A
  • decreased FVC, DLCO (in intrinsic)

- normal FEV1:FVC

39
Q

How can you differentiate between intrinsic and extrinsic RLD?

A

DLCO low in intrinsic (interstitial lung disease and lung resection) and normal in extrinsic (disease of the pleura, chest wall, neuromuscular disorders)

40
Q

What will the DLCO/Va (correction for the amount of lung) show in lung resection?

A

100% (assuming no other disease)- keep in mind that DLCO will be 50% and other stats may look restrictive

Pulmonary Week 2 (25 decks)

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