Restrictive Lung Dz Flashcards
Normal FVC
80% of predicted
Normal FEV1
80% of predicted
Normal FEV1/FVC
80% of predicted
Extrathoracic airway obstruction is worse during…
inspiration because Patm is greater than Ptr so particles move inward toward trachea, worsening the obstruction
Intrathoracic airway obstruction is worse duirng…
exhalation because pleural pressure is greater than tracheal pressure
Low ratio, low DLCO
low ratio= obstructive. Low DLCO= emphysema
Low ratio, normal DLCO
Bronchitis
Low ratio, high DLCO
low ratio- obstructive. HIgh DLCO- asthma
Low VC, low DLCO
restrictive, interstitial fibrosis
Categories of ILD
ILD of known cause, Idopathic interstitial pneumonia, granulamatous ILD (sarcoidosis), and other forms of ILD
What abnormal breath sounds would you hear in IPF?
Bilateral, High pitched, fine late inspiratory crackles in lung bases
HRCT of IPF
Diffuse fibrosis in lung bases and periphery , honeycombing, cyst formation, UIP
UIP
Usual interstitial pneumonia- progressive scarring of both lungs
Is IPF extraparenchymal?
No, it is limited to the lung
Cause of IPF
Unknown
Risk factors for IPF
Smoking, family history of IPF, antidepressants, chronic aspiration, infectious agents, environmental factors
If you suspect someone of IPF but signs and symptoms are suggestive of systemic disorder, what to do?
Suggest alternate diagnosis, IPF limited to lung
Describe IPF’s patients cough
Would be nonproductive, dry
Is the onset of IPF rapid or slow? When does patient present?
Insidious- GRADUAL onset of nonproductive cough and dyspnea. patient presents late in course of disease. Usually will present with dyspnea which is progressive and present for more than 6 months before presentation
PE of IPF
Fine, high pitched late inspiratory crackles in lung bases, cyanosis, pulmonary HTN, cor pulmonale
Angle in clubbing of fingers
More than 180 degrees
You suspect your patient of IPF. He has a fever. What does this tell you?
Fever suggestive of systemic disease process,IPF is limited to the lung. If fever, might be connective tissue disease like rheumatoid arthiritis
Associated symptoms with IPF
Weight loss, malaise, fatigue
What is nice about CXR of patient with IPF?
Almost all will have abnormal CXR! Makes diagnosis a bit easier- bilateral basilar interstitial infiltrates, decreased lung volume (in sync with restrictive lung dz), honeycombing, subpleural cysts, traction bronchiectasis (stretchy walls). CT shows reticular, patchy abnormalities and GROUND GLASS opacities