W2e2

Question 1

What are some of the causes of thoracic restriction in restrictive lung disease

Answer 1

1. Deformities of the dorsal or thoracic vertebrae (curving of spine)
2. Inflammation of the spine causes fusion
3. Ribs fracturing
4. Intercostal or diphragmatic muscles becoming weakened due to disease or nerves, spinal cord or muscles.
5. Abdominal obesity/ fluid in abdominal cavity/ pregnancy

All mean the lungs cannot expand properly

Question 2

What are some of the causes (5) of restrictive lung disease in terms of interstitial lung disease (dpld)

Answer 2

Alveoli arteriola barrier (important in gas exchange) having some issue due to:

1. Fluid in alveolar air space
2. Consolidation of air spaces
3. Inflammatory response in alveoli walls (known as alveolitis)
4. Inhalation of dust (known as pneumoconiosis)
5. Carcinoma

Question 3

What can cause (3) consolidation of the air spaces in DPLD?

Answer 3

1. Infection- virus, bacteria, fungus, parasite
2. Infarction (tissue death due to lack of blood supply)- due to pulmonary emboli
3. Bronchiolitis obliterans organising pneumonia (BOOP)- due to inflammation of bronchioles/ surrounding tissue

Question 4

What can trigger non- specific alveolitis?

Answer 4

1. Drugs (amiodarone- treats irregular heart beats)
2. Inhalation of toxic fumes (chlorine)
3. Pulmonary fibrosis (scarring) privy to inflammation causing deposition of collagen
4. Autoimmune- production of auto antibodies
5. Inhalation of dust- a. Asbestosis (destructive work from buildings) b. Silicosis (silicon)

Question 5

In pneumoconiosis (inhalation of dust) what are some chemicals that are fibrogenic (promote fibre development (2)) and non fibrogenic (3)

Answer 5

Non- Fibrogenic:

1. Siderosis (iron)
2. Stanosis (tin)
3. Baritosis (barium)

fibrogenic

1. Asbestosis (from destroyed buildings)
2. Silicosis (silicon)

Question 6

What are the clinical presentations of DPLD (diseases affecting the tissue and space around the alveloli)

Answer 6

1. Finger clubbing
2. Cough but no wheeze
3. Breathlessness on exertion
4. Inspiratory lung crackles
5. Central cyanosis (only when hypoxic)
6. Pulmonary fibrosis (scarring) (when chronic inflammation)
7. Peak flow normal
8. Reduced lung volumes but fev1/fvc normal (above 75%)

Question 7

What are some of the treatments for dpld?

Answer 7

1. Removal of triggers
2. Immunosuppresives (to prevent inflammation) like corticoid steroids through systemic
3. Drugs to prevent consolidation by calcium deposition like nintedanib