Pathology of restrictive lung disease Flashcards

1
Q

what is the intersitum of the lungs

A

connective tissue space around the airways and vessels. And the space between the basement membranes of the alveolar wall

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2
Q

would a CXR of a patient with restrictive lung disease be normal or abnormal

A

abnormal as it would show lung restriction

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3
Q

what is ARDS

A

lungs become severely inflamed as a result of an infection or injury. The inflammation causes fluid from nearby blood vessels to leak into the tiny air sacs in your lungs, making breathing increasingly difficult.

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4
Q

what are the clinical symptoms of restrictive (interstitial) lung disease

A

reduced lung compliance
low FEV1 and FVC
reduced gas transfer
V/Q mismatch

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5
Q

does interstitial lung disease limit airflow

A

no airflow limitation

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6
Q

what happens to the lung when it undergoes diffuse alveolar damage (DAD)

A

edema in response to injury
hyaline membrane forms
later interstitial inflammation and fibrosis are seen

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7
Q

what are restrictive lung diseases characterized by

A

reduction in FRC

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8
Q

what is the end stage of interstitial lung disease

A

fibrosis of the lung this is irreversible

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9
Q

what are some histological features of DADS

A

protein rich oedema
fibrin
hyaliine membranes
denuded basement membranes

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10
Q

what cells proliferate in DADS

A

epithelial proliferation

fibroblast proliferation

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11
Q

what is sarcoidosis

A

idiopathic inflammatory disease induced by Th cells which leads to granulomas-very common in the lungs

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12
Q

what is the typical clinical presentation of sarcoidosis in a young adult

A

acute arthralgia
erythema nodosum
bilateral hilar lymphadenopathy

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13
Q

what are the symptoms a patient may report if they have sarcoidosis

A

SOB
cough
joint pain (acute arthralgia)

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14
Q

what serum test can be did to diagnose sarcoidosis

A

ca in blood

ACE enzyme in blood

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15
Q

what is hypersensitivity pneumonitis

A

Hypersensitivity inflammatory reaction to a breathed in antigen. leads to inflammation in the lungs

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16
Q

what are 2 thermophillic actinomycetes that can cause hypersensitivity pneumonitis

A

Micropolyspora faeni

Thermoactinomyces vulgaris

17
Q

what types of hypersensitivity reaction is hypersensitivity pneumonia

A

type 3 and 5

18
Q

what is the typical acute presentation of HP

A

fever dry cough myalgia
chills
crackles tachyopnoea wheeze
percipitating anti body

19
Q

what is the typical chronic presentation of HP

A

malaise SOB cough
crackles some wheeze
insidious

20
Q

what is Usual interstitial pneumonitis (aka idiopathic lung disease)

A

progressive scarring of the lungs due to repeated injury to alveoli epithelium

21
Q

what disease are proliferating fibroblastic foci found in

A

usual interstitial pneumonitis

22
Q

what age group of people present with UPI

A

the elderly

23
Q

what symptoms would a patient with IPF present with

A
dyspnoea
cough
basal crackles
cyanosis
clubbing
24
Q

what is the prognosis for IPF

A

most dead within 5 years

25
Q

what is the normal values for PaO2

A

10.5-13.5 kPa

26
Q

what are the normal values for PaCo2

A

4.8-6.0 kPa

27
Q

to be classed as respiratory failure what lvl will a patients PaO2 be at

A

less than 8 kPa PaO2

28
Q

in type II respiratory failure what will the levels of a patients PaO2 and PaCO2 be at

A

PaCO2 >6.5 kPa

PaO2 usually low

29
Q

alveolar hypo-ventilation causes an increase in what gas

A

Hypoventilation increases PACO2

30
Q

in alveolar hypo ventilation there is an increase in PaCO2 what happens to the PaO2

A

Increase in PACO2 decreases PAO2, which causes PaO2 to fall

31
Q

what does FIO2 stand for

A

fraction of inspired air which is oxygen

32
Q

what is the commonest cause of hypoxaemia encountered clinically

A

low V/Q

33
Q

how does hypoxaemia due to low V/Q respond to increased FIO2

A

very well even to small increases

34
Q

what are the causes of diffuse alveolar damage

A
Major trauma
Chemical injury / toxic inhalation
Circulatory shock
Drugs 
Infection
Auto(immune) disease
Radiation
35
Q

what effect do diseases impairing gas diffusion have on CO2 levels

A

usually do NOT change CO2 levels