Pulmonary Pathology: Restrictive Lung Disease Flashcards Preview

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Flashcards in Pulmonary Pathology: Restrictive Lung Disease Deck (43):
1

cardiovascular causes of restrictive lung dysfunction

-pulmonary edema
-pulmonary emboli

2

Neuromuscular Causes of restrictive lung dysfunction

-SCI
-ALS
-Polio
-Guillain-Barre Syndrome
-Myasthenia Gravis
-Tetanus
-Duchenne's Muscular Dystrophy

3

Connective Tissue Causes of restrictive lung dysfunction

-RA
-SLE
-Polio

4

Nutritional and Metabolic Causes of restrictive lung dysfunction

-Obesity
-DM

5

Traumatic Causes of restrictive lung dysfunction

-crush injuries
-penetrating wounds
-thermal trauma

6

Immunologic Causes of restrictive lung dysfunction

-Goodpasture's syndrome
-Wegener's Granulomatosis

7

Therapeutic Causes of restrictive lung dysfunction

-surgical therapy
-lung transplant
-drug therapy
-radiation therapy

8

Hospital-Acquired Pneumonia

-infection of lower respiratory tract beginning 72 hours + after hospitalization
-most common cause: pseudomonas aeruginosa
-Risk factors: tubes in throat, dysphagia, lung injury, diabetes, chronic cardiopulm disease, infection, smoker

9

Thoracic Cage Changes Due to:

-kyphoscoliosis
-ankylosing spondylitis

10

Common restrictive primary problems

-decreased compliance
-decreased lung volume & capacity
-increased WOB

11

Cor Pulmonale

R ventricular hypertrophy

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Limited diaphragm displacement due to:

-obesity
-ascites

13

Alveolar compression caused by

-pleural effusion

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Decreased compliance due to:

-stiffening of lung parenchyma
-alveolar compression
-thoracic changes
-limited diaphragm displacement

15

Restrictive

-trouble getting air in

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Lung parenchyma stiffening from:

-interstitial fibrosis
-sarcoidosis
-scleroderma

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Common restrictive symptoms

-dyspnea
-dry, nonproductive cough
-wasted, emaciated appearance

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Common Restrictive Signs

-tachypnea
-vent-perf mismatching
-decr breath sounds
-decr lung volume and capacity
-cor pulmonale

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Common restrictive diseases

-RDS
-BOOP
-Pneumonia
-ARDS
-Idiopathic Pulmonary Fibrosis

20

ARDS
Pathophysiology

-exact mechanism unknown

-damage to capillary & alveolar endothelial cells-->
-incr permeability-->
-fluid & protein leave capillaries to interstitial fluid & alveoli-->
-decr lung vol & capacity & compliance-->
-Incr PVR-->
-R to L shunt-->
decr vent-perf matching-->
-alveolar fibrosis and los of capillaries

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ARDS
Etiology

-trauma
-shock
-blood transfusion
-pneumonia
-metabolic
-drugs
-inhaled toxins
-aspiration

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ARDS
Prognosis

80% survival rate

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ARDS
Treatment

-treat cause
-maintain gas exchange (vent)
-supportive (nutrition, electrolytes, fluid)
-Prevent complications
-positioning
-prone

24

BOOP

Bronchiolitis obliterans w/ organizing pneumonia

aka. bronchiolitis fibrosa obliterans, follicular bronchiolitis, bronchiolitis w/ diffuse interstitial pneumonia

25

BOOP
Pathophysiology

-necrosis of epithelium in affected bronchioles-->
-accum fluid/debri-->
-pulm edema with obstruction of small airways-->
-atelectasis from collapsed airways-->
-inflamation-->
-fibrosis of bronchial tree and alveoli

26

BOOP
Etiology

-result of having something else
-fibrotic lung disease of smaller airways
-can cause restrictive or obstructive lung diseases
-children: viral infection
-adults: viral, bacterial, mycobacterial infections, toxic fumes, connective tissue diseases (RA), graft vs host reactions

27

BOOP
Treatment

-Kids: supportive (O2, hydration, postural drainage, suctioning)

-Adults: supportive (O2, hydration, corticosteroids

28

IPF

Idiopathic Pulmonary Fibrosis

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Idiopathic Pulmonary Fibrosis
Pathophysiology

-localized inflammatory changes (alveolitis) progressing to scarring and fibrosis
-alveoli irregular in size/shape
-capillaries destroyed

30

Idiopathic Pulmonary Fibrosis
Etiology

-unknown
-immunnologically mediated response to acute injury or infection

31

Idiopathic Pulmonary Fibrosis
Treatment

-corticosteroids
-cytotoxic meds
-supportive (O2, vent)
-lung transplant

32

Types of Pneumonia

-community-acquired
-hospital acquired (nosocomial)

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Community Acquired Pneumonia

-most can be tracked to cause (bacterial mostly)
-streptococcus pneumoniae (pneumococcus) most common

34

Pneumonia
Pathophysiology

-agent enters through inhalation/aspiration
-bacterial/viral

35

Pneumonia
Etiology

-5th leading cause of death in US
-inflm of lung parenchyma from exposure to microbes

-(bacteria, mycoplasms, viruses, protozoa, psittacosis agents)

36

Bacterial Pneumonia

--1st response to infection is edema then polymorphonuclear leukocytes (phagocytosis) and deposits of fibrin

37

Bacterial Pneumonia
Treatment

-antibiotics
-supplemental O2 as needed
-pulm hygiene
-hydration
-nutrition

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Viral Pneumonia

-1st localizes in epithelial cells and destroys cilia and mucosal surfaces
-may proceed to alveoli-->edema, hemorrhage, hyaline membrane formation or ARDS

39

Viral Pneumonia
Treatment

-supportive
-few antivirals available

40

RDS
Pathophysiology

-absence/inadequate surfactant
-abnormal alveolar and epithelial & endothelial permeability
-pulmonary HTN

41

RDS
Etiology

(hyaline membrane disease)
-gestation <36 weeks (no surfactant)
-more in males
-delivered by c-section
-mother has diabetes (insulin delays surfactant production)
-born with PDA

42

RDS
Prognosis

-progressively worse for 2-4 days then improves
-potential for BPD

43

RDS
Treatment

-mechanical vent (-->BPD)
-supplemental O2
-CPAP
-Surfactant replacement
-medications (sedation, pain relief)