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Pathology > Restrictive Lung Disorders > Flashcards

Restrictive Lung Disorders Flashcards

1
Q

Spirometry findings in Restrictive lung disorders

A

TLC decreases
FVC decreases
FEV1 - Normal or slightly decreased
FEV1/FVC Increases
Fibrosis - decreased lung compliance
Diffusion capacity decreases

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2
Q

Causes of Restrictive lung disorders can be classified into

A

Extra parenchymal causes
Parenchymal cause

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3
Q

Extra parenchymal causes in RLD includes

A

Chest wall disorders - Obese/ Kyphosis/ Ankylosis spondylitis
Neuromuscular disorders - Diaphragmatic palsy, Myasthenia gravis, Gullian Barre syndrome
Muscular dystrophy

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4
Q

Parenchymal cause of RLD can be classified to

A

Acute
Chronic

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5
Q

Acute parenchymal causes of RLD

A

ARDS

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6
Q

Chronic parenchymal causes of RLD can be divided to

A

Fibrosing
Granulomatous
Eosinophilic
Smoking related

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7
Q

Fibrosing parenchymal causes include

A

Idiopathic pulmonary fibrosis (IPF)
Non specific interstitial pneumonia (NSIP)
Cryptogenic organising pneumonia (COP)
Pneumoconiosis

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8
Q

Granulomatous parenchymal causes includes

A

Hypersensitivity pneumonitis
Sarcoidosis

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9
Q

Eosinophilic parenchymal causes includes

A

Loffler syndrome
Drug allergy

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10
Q

Smoking related parenchymal causes includes

A

DIP
Resp. Bronchiolitis

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11
Q

Idiopathic pulmonary fibrosis also termed as

A

Cryptogenic fibrosing alveolitis

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12
Q

Pathogenesis of Idiopathic pulmonary Fibrosis (IPF)

A

Environmental factors (GERD/Smoking etc) - alveolar epithelial cell injury (Alveolitis) - TGF- beta secretion - Fibrous tissue deposition

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13
Q

Lobes involved in IPF

A

Bilateral Lower lobes
Subpleural location
Along interlobular septum

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14
Q

Commonly affected age group in IPF

A

Elderly patients

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15
Q

Clinical features of IPF

A

M > F
Dyspnea on exertion
Dry cough
Dry inspiratory crackles

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16
Q

Diagnosis of IPF

A

Clinical Presentation
Surgical biopsy
Radiology - HRCT Scan

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17
Q

Findings of surgical biopsy in case of IPF

A

Usual interstitial pneumonia
Patchy interstitial fibrosis
Architecture distortion
Honeycombing pattern microscopically

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18
Q

Treatment of IPF

A

Lung transplant
Pirfenidone - inhibits TGF-beta activity
Nintedanib

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19
Q

In case of massive fibrosis in IPF

A

Leads to death in 3 years

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20
Q

Cause of Non specific Interstitial pneumonia (NSIP)

A

Idiopathic

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21
Q

NSIP is associated with connective disorders except

A

Rheumatoid arthritis

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22
Q

Clinical features of NSIP

A

Dry cough
Progressively increasing dyspnea
Age - 50-60 years

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23
Q

NSIP commonly seen in

A

Non smoker females

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24
Q

Heterogenous fibroplastic foci is seen in

A

IPF

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25
Q

Diagnosis of NSIP

A

HRCT Scan
Surgical biopsy

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26
Q

Most common lobe involved in NSIP

A

Lower lobe

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27
Q

Surgical biopsy findings in NSIP

A

Uniform/homogeneous involvement - same pattern

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28
Q

Cellular variant of NSIP includes

A

Chronic Inflammatory cells +ve
Fibrous tissue -ve

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29
Q

Fibrosing NSIP includes

A

Chronic Inflammatory cells + fibrosis +ve

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30
Q

Clinical features of Cryptogenic Organising pneumonia (COP)

A

Cough
Dyspnea

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31
Q

Diagnosis methods used in COP

A

Surgical biopsy

32
Q

Surgical biopsy findings in case of COP

A

Masson body - loose C.T

33
Q

Treatment of COP

A

Steroids

34
Q

Pigmented or Smokers macrophages are seen in

A

Desquamative Interstitial pneumonia

35
Q

Treatment of Desquamative Interstitial pneumonia

A

Quit smoking
Steroids

36
Q

In Respiratory bronchiolitis

A

Pigmented intraluminal macrophages +ve
Resp. Bronchioles involvement

37
Q

Pneumoconiosis means

A

Diseases due to occupational hazards

38
Q

Pneumoconiosis pathogenesis

A

Ingestion of dust particles with breathing air - activates alveolar Macrophages - can leads to Fibrosis

39
Q

Size of dust particles leading to Pneumoconiosis

A

1-5 micron in size

40
Q

Most common pneumoconiotic disease

A

Silicosis

41
Q

Inhalation of silica occurs in which occupations

A

Sand mining
Stone crushing

42
Q

Which lobe is commonly involved in Silicosis

A

Upper lobe

43
Q

Findings on polarised microscopy in case of Silicosis

A

Shiny birefringent crystals

44
Q

Chest X ray finding in case of Silicosis

A

Egg shell calcification

45
Q

Which industry is commonly involved in Asbestosis

A

Insulation industry

46
Q

Asbestos is

A

Tumor initiator or tumor promoter
Dangerous chemical

47
Q

Multiple type of lesions seen in Asbestosis

A

Pleural plaque (MC)
Interstitial fibrosis

48
Q

Body seen in Asbestosis

A

Ferruginous or Asbestos body - dumble like structure

49
Q

Calcium levels in case of Asbestosis

A

Increased

50
Q

Exposure of asbestos particle for 15-25 years can leads to

A

Bronchogenic carcinoma

51
Q

Exposure of asbestos particles for 25-40 years can leads to

A

Malignant mesothelioma

52
Q

Stages of Coal dust Pneumoconiosis

A

Stage 1 - Anthracosis
Stage 2 - Simple coal worker Pneumoconiosis
Stage 3 - progressive massive fibrosis

53
Q

Anthracosis is

A

Asymptomatic coal worker disease
Microscopically deposition of coal pigment in alveolar Macrophages

54
Q

Simple coal worker Pneumoconiosis

A

Small nodules in lungs
Centriacinar emphysema

55
Q

Progressive massive Fibrosis in coal dust Pneumoconiosis is reversible or irreversible

A

Irreversible

56
Q

Coal worker Pneumoconiosis+ Rheumatoid arthritis

A

CAPLAN Syndrome

57
Q

Inhalation of cotton fibers is termed as

A

Byssinosis

58
Q

Inhalation of sugarcane dust is termed as

A

Baggassosis

59
Q

Berryliosis is more common in

A

Aerospace industries

60
Q

Sarcoidosis is a

A

Multi system disorder
Immune dysregulation

61
Q

Genes associated with Sarcoidosis

A

HLA A1/B8

62
Q

Sarcoidosis is most commonly seen in which gender

A

F >M
Non smokers most frequently

63
Q

Pathophysiology of Sarcoidosis

A

Unknown antigen - activates CD4 T cells - Cytokines secretion - TNF-alpha - Bronchoalveolar lavage fluid

64
Q

Granuloma seen in Sarcoidosis

A

Non caseating granuloma

65
Q

Clinical features of Sarcoidosis

A

MC involves lungs and lymph nodes - Bilateral hilar lymphadenopathy (Potato nodes)
Dyspnea
Cough
Low grade fever
Weight loss
Also involves skin/eye/lacrimal gland/spleen/liver/BM

66
Q

Skin related findings in Sarcoidosis

A

Lupus pernio - pinkish or purplish rash on cheek or tip of nose
Erythema nodusum - painful nodes on lower limbs

67
Q

Lofgren Syndrom

A

Includs triad of
Erythema nodusum
Arthralgia
Bilateral hilar lymphadenopathy

68
Q

Eye related clinical finding in Sarcoidosis

A

Uveitis

69
Q

Lacrimal and salivary glands in Sarcoidosis

A

Mickulics syndrome - dry eyes, dry mouth

70
Q

Granuloma formation is seen in which organs in case of Sarcoidosis

A

Spleen
Liver
BM

71
Q

Endocrine gland most commonly affected in Sarcoidosis

A

Pituitary gland

72
Q

Diagnosis of Sarcoidosis

A

Diagnosis of exclusion
S. ACE elevated
Increased activity of 1alpha hydroxylase - increased production of active form of vit D - Hypercalcemia
Bronchioalveolar lavage fluid(BAL) - CD4 : CD 8 ratio - 5-15:1

73
Q

Findings of lymph node biopsy in Sarcoidosis

A

Non caseating granuloma
Intracellular inclusion bodies
Residual body
Asteroid body - Star shaped body
Schaumann body - Bluish color material deposited in giant cells

74
Q

Kveim test procedure

A

Extract tissue of spleen from known case of Sarcoidosis - intradermally injected into suspected patient - after 4-6 weeks - finds non - caseating granuloma

75
Q

Treatment of Sarcoidosis

A

Spontaneous remission
Steroids

Pathology (14 decks)

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