Restrictive Vs Obstructive Lung Disease

Question 1

FEV1/FVC ratio of 0.81 - what is the pattern?

Answer 1

Restrictive pattern - likely pulmonary fibrosis

Question 2

Restrictive lung disease is characterised by …

Answer 2

Reduced lung volume with an increase in the FEV1/FVC ratio

Question 3

Causes of restrictive lung disease

Answer 3

Parenchymal lung disease, chest wall abnormalities, pleural + neuromuscular disease
Parenchymal disease leads to fibrosis and progressive dyspnoea
Poor gas transfer in Parenchymal disease (reduced DLCO)

Question 4

Overview of obstructive vs restrictive lung disease

Answer 4

Question 5

Is cystic fibrosis obstructive or restrictive?

Answer 5

Obstructive

Question 6

Cystic fibrosis is due to a mutation in the CFTR gene

What is the function of the gene product?

Answer 6

Epithelial chloride channel

Question 7

What is Cystic fibrosis?

Answer 7

Autosomal recessive multi-system disease that affects the lungs
Mutation in CFTR that encodes a regulatory chloride channel
Thousands of mutations, most commonly identified is delta F508
Altered airway secretions (thick, difficult to clear) with recurrent infections + bronchiectasis

Question 8

What should be done?

Answer 8

Urgent referral for CXR - cancer suspected (wt loss)

Question 9

Always suspect … in older patients (>40) with unexplained chest symptoms

Answer 9

Always suspect lung cancer

Question 10

Request an urgent CXR if over … and unexplained chest symptoms and/or features of cancer

Answer 10

Over 40

Question 11

Remember to offer…

Answer 11

Smoking cessation