Restrive Lung Disease Flashcards

1
Q

What is the interstitium of the lung?

A

The space between the basement membranes of the alveolar walls

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2
Q

What happens during interstitial lung disease?

A

Pathological material is laid down in the interstitium which thickens the alveolar walls reducing gas exchange

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3
Q

What is the result of interstitial lung disease?

A
Reduced lung compliance 
Low FEV1 
Low FVC 
FEV1/FVC ratio normal 
Reduced gas transfer 
V/Q imbalance
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4
Q

What are the possible presentations of interstitial lung disease?

A

Asymptomatic
Dyspnoea
Type 1 respiratory failure
Heart failure

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5
Q

What are the three types of chronic response to interstitial lung injury?

A

UIP
Granulomatous response
Other patterns

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6
Q

What can interstitial lung injury lead to?

A

End-stage honeycomb lung

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7
Q

What type of chronic response is most likely to develop into fibrosis?

A

Usual interstitial pneumonitis

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8
Q

What causes diffuse alveolar damage?

A
Major trauma 
Chemical injury
Circulatory shock 
Drugs 
Infection 
Autoimmune disease
Radiation
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9
Q

What are the histological features of DAD?

A
Protein rich oedema 
Fibrin 
Hyaline membranes 
Denuded basement membrane 
Epithelial proliferation 
Fibroblast proliferation 
Scarring of the interstium and the airspaces
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10
Q

What diseases come as part of the granulomatous response?

A

Sarcoidosis

Hypersensitivity pneumonitis

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11
Q

What is the most common interstitial lung disease?

A

Sarcoidosis

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12
Q

What are the histological features of sarcoidosis?

A

Epithelioid and giant cell granulomas
Necrosis/ caseation very unusual
Little lymphoid infiltrate
Variable associated fibrosis

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13
Q

What are the most common sites of sarcoidosis?

A

Lungs

Intrathoracic lymph nodes

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14
Q

What is the acute presentation of hypersensitivity pneumonitis?

A
Fever
Dry cough 
Myalgia 
Chills 
Crackles 
Tachypnoea 
Wheeze 
Precipitating antibody
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15
Q

What is the chronic presentation of hypersensitivity pneumonitis?

A
Insidious
Malaise
SOB 
Cough
Low grade illness	
Crackles and some wheeze
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16
Q

What are the histological features of hypersensitivity pneumonitis?

A

Soft centriacinar epithelioid granulomata
Interstitial pneumonitis
Foamy histiocytes
Bronchiolitis obliterans

17
Q

What is hypersensitivity pneumonitis?

A

An immune complex mediated combined Type 3 and Type 4 hypersensitivity reaction

18
Q

What are the possible causes of UIPs?

A
Connective tissue disease 
Drug reaction 
Post infection 
Industrial exposure
Idiopathic
19
Q

What are the histological features of UIP?

A

Patchy interstitial chronic inflammation
Type II pneumocyte hyperplasia
Smooth muscle and vascular proliferation
Proliferating fibroblastic foci

20
Q

What are the signs and symptoms of UIP?

A
Dyspnoea 
Cough 
Basal crackles 
Cyanosis 
Clubbing