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RESPIRATORY > Restrictive Lung Diseases > Flashcards

Restrictive Lung Diseases Flashcards

1
Q

Thoracic restriction can be due to causes ……. the lungs

A

OUTWITH

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2
Q

Name some skeletal causes of thoracic lung restriction.

A

Vertebrae e.g thoracic kyphoscoliosis
Ankylosing spondylitis
Rib fractures

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3
Q

Name some muscular causes of thoracic lung restriction

A

Muscle weakness e.g myopathy, neuropathy
MND
Polio
Gulian Barre

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4
Q

Name 2 conditions that can cause compression of the thoracic contents.

A

Ascites

Obesity

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5
Q

What does thoracic restriction result in?

A

Chronic alveolar under-ventilation with low PaO2 and raised PaCO2 and reduced lung volumes

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6
Q

Describe the 5 main categories of DPLD.

A
  1. Acute DPLD
  2. Episodic DPLD, all of which may present acutely
  3. Chronic DPLD due to occupational or environmental agents or drugs.
  4. Chronic DPLD with evidence of systemic disease
  5. Chronic DPLD with no evidence of systemic disease
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7
Q

What is DPLD? What is it also know as?

A

A group of lung diseases affecting the lung parenchymal e.g alveolar lungs/lumen
Interstitial lung disease

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8
Q

What is impaired as a result of DPLD? What does this mean?

A

Alveolar gas exchange is impaired

There is an alveolar barrier to O2 exchange

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9
Q

What remains normal in DPLD?

A

Alveolar ventilation

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10
Q

What does the normal alveolar ventilation mean?

A

CO2 exchange is unimpaired

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11
Q

What is the main cause of DPLD?

A

Fluid in the alveolar spaces

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12
Q

Name a cardiac condition that could result in fluid in the alveolar spaces. Explain this.

A

LVF
Raised pulmonary venous pressure due to back pressure from the heart
Accumulation of oedema in alveolar walls and lumen

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13
Q

Name other conditions which could lead to a build up of fluid in the lungs BUT with normal pulmonary pressure.

A 
Leaky vessels, normal pressure
Sepsis
Trauma
ARDS
Altitude sickness
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14
Q

DPLD can also be caused by …………. in alveolar spaces

A

Consolidation

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15
Q

Name some causes of consolidation in alveolar spaces.

A

Pneumonia
Infarction
Rheumatoid drugs

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16
Q

What kind of infarction can lead to DPLD?

A

PE

Vasculitis

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17
Q

What different types of pneumonia can cause consolidation in the lungs? Give examples under each heading.

A

Viral - flu, measles, chickenpox
Bacterial - pneumococcus, TB
Fungal - HIV, pneumocystitis

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18
Q

Inflammatory infiltrate in alveolar walls is another cause of DPLD

A

TRUE

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19
Q

What is alveolitis?

A

Inflammatory infiltrate in alveolar walls

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20
Q

Name the 2 main types of granulomatous alveolitis.

A

Extrinsic Allergic Alveolitis

Sarcoidosis

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21
Q

What can EAA also be called?

A

Hypersensitivity Pneumonitis

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22
Q

What type of hypersensitivity reaction is EAA?

A

Type 3

23
Q

Name a common sign of Sarcoidosis.

A

Chronic enlargement of lymph nodes

24
Q

Sarcoidosis is a …..-system disease

A

MULTI

25
Q

Name 4 common symptoms that accompany Sarcoidosis.

A

Erythema Nodosum
Uveitis
Myocarditis
Neuropathy

26
Q

Alveolitis can also be drug induced. Name some common drugs that cause this condition.

A

Amiodarone
Gold
Methotrexate
Bleomycin

27
Q

What toxic gas can cause alveolitis?

A

Chlorine

28
Q

Name 3 auto-immune conditions which are associated with Alveolitis.

A

SLE
Polyarteritis
Wegeners

29
Q

What is the conditions known as ‘dust disease’?

A

Pneumoconiosis

30
Q

There are 2 types of pneumoconiosis, what are they?

A

Fibrogenic

Non-fibrogenic

31
Q

Name 2 conditions under the heading of Fibrogenic Pneumoconiosis

A

Asbestosis

Silicosis

32
Q

Name 5 signs/symptoms of DPLD.

A 
SOB on exertion
Cough 
Clubbing
Inspiratory crackles (base)
Central cyanosis
33
Q

What occurs as an end stage response to inflammation?

A

Pulmonary fibrosis

34
Q

The cough in DPLD is associated with a wheeze

A

FALSE

NO wheeze

35
Q

Describe what would be heard on auscultation of the lungs in a patient with DPLD.

A

Fine, inspiratory crackles

Base of lungs

36
Q

DPLD patients have reduced lung volumes. Describe this.

A

FEV1 and FVC - DECREASED

Normal ratio >75%

37
Q

People with DPLD have a normal peak flow

A

TRUE

38
Q

Those with DPLD have increased gas diffusion

A

FALSE - decreased

39
Q

Describe the arterial oxygen DESATURATION is DPLD.

A

Decreased PaO2 at rest and during exercise

40
Q

Outline some other tests that should be done in the diagnosis of DPLD.

A
  1. Antibodies
  2. Serum ACE and Ca
  3. CXR
  4. ECHO
  5. CT
  6. BAL
  7. Biopsy
41
Q

Antibodies

A

Avian
Fungal
Auto-antibodies

42
Q

Serum ACE and Ca

A

Sarcoidosis

43
Q

CXR

A

Bilateral diffuse alveolar infiltrates

44
Q

ECHO

A

LVF

45
Q

CT

A

Inflammatory ground glass

Fibrotic nodular component of alveolar infiltrates

46
Q

BAL

A

Infection
TB
Pneumocystitis

47
Q

Biopsy

A

Rare

48
Q

What is always the FIRST step in the treatment of DPLD?

A

Remove any triggers

e.g dust, drug, allergen

49
Q

What should be given if the patient is hyperaemic?

A

O2 obvs

50
Q

What is the 1st and 2nd line of treatment in DPLD?

A
  1. Systemic corticosterone e.g oral Prednisolone
  2. Oral Azothioprine
  3. Anti-fibrotic (IPF)
  4. Anti-oxidant (IPF)
51
Q

What is the last resort for end stage disease?

A

Lung transplant

52
Q

Bilateral nodular lymphadenopathy and lung infiltrates

A

Sarcoidosis

53
Q

What type of granulomas are found in Sarcoidosis?

A

Non-ceseating

RESPIRATORY (14 decks)

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