Restrictive Lung Disease

Question 1

What does restrictive lung disease cause a decrease in

Answer 1

Total lung capacity

Question 2

2 major categories of restrictive lung disease

Answer 2

Intrinsic
Extrinsic

Question 3

What causes intrinsic restrictive lung disease

Answer 3

Lung parenchyma inflammation and scarring

Question 4

What causes extrinsic restrictive lung disease

Answer 4

Abnormal function of chest wall, pleura, and neuromuscular apparatus

Question 5

Which type of restrictive lung disease decreases alveolar-arterial gas transfer, and leads to exudate and debris in lungs

Answer 5

Intrinsic

Question 6

Which type of restrictive lung disease causes impaired ventilator function and respiratory failure

Answer 6

Extrinsic

Question 7

DPLD

Answer 7

Diffuse parenchymal lung diseases

Question 8

Is interstitial lung disease a type of intrinsic lung disease or is intrinsic lung disease a type of interstitial lung disease

Answer 8

Interstitial is a type of intrinsic

Question 9

3 major interstitial lung diseases

Answer 9

Idiopathic pulmonary fibrosis
Sarcoidosis
Pneumoconiosis

Question 10

Are interstitial lung diseases usually common or rare

Answer 10

Rare

Question 11

Idiopathic pulmonary fibrosis risk factors

Answer 11

Smoking
Chronic viral infections
Abnormal acid reflux
Family history

Question 12

Why is breathing and oxygen exchange restricted in idiopathic pulmonary fibrosis

Answer 12

Scarring/honeycombing of lungs

Question 13

What causes scarring and honeycombing of lungs in idiopathic pulmonary fibrosis

Answer 13

Collagen deposits and fibrotic plaques

Question 14

What is believed to cause idiopathic pulmonary fibrosis

Answer 14

Decreased epithelial cell integrity
Accelerated age associated changes
Exaggerated fibroblast expansion

Question 15

What lung changes are caused by idiopathic pulmonary fibrosis

Answer 15

Traction bronchiectasis
Alveolar remodelling - collagen + fibrotic plaques
Parenchymal fibrosis

Question 16

Idiopathic pulmonary fibrosis signs and symptoms

Answer 16

Exertional Dyspnoea
Clubbing
Dry cough
Bibasilar inspiratory crackles
Restrictive flow volume spirometry

Question 17

DLCO - diffusing capacity of the lungs for CO

Answer 17

Quantity of CO transferred per minute from alveolar gas to RBCs

Question 18

DLCO equation

Answer 18

Lung surface area available for gas exchange (Va) X rate of capillary blood CO uptake (Kco)

Question 19

How does interstitial lung disease affect DLCO

Answer 19

Decrease

Question 20

What chest HRCT findings confirm idiopathic pulmonary fibrosis

Answer 20

Reticular changes associated with traction bronchiectasis and honeycombing

Question 21

Recommended Idiopathic pulmonary fibrosis drugs

Answer 21

Pirfenidone
Nintedanib
Antacid therapy

Question 22

Pirfenidone

Answer 22

Anti fibrotic agent used in COPD treatment

Question 23

Pirfenidone adverse affects

Answer 23

GI effects
Photosensitivity
Anorexia
Skin rash
Liver toxicity

Question 24

Nintedanib

Answer 24

Tyrosine kinase inhibitor

Question 25

Nintedanib adverse effects

Answer 25

Diarrhoea Weight loss Liver toxicity

Question 26

Antacid therapy adverse effects

Answer 26

Infection Cognitive function MI

Question 27

Non pharmacotherapy idiopathic pulmonary fibrosis treatments

Answer 27

Pulmonary rehab Long term oxygen Lung transplant

Question 28

Sarcoidosis

Answer 28

Inflammatory disease causing multi system granulomas due to immune system overdrive

Question 29

Why does sarcoidosis often not require treatment

Answer 29

Acute and self limiting

Question 30

Sarcoidosis symptoms

Answer 30

Dry eyes Blurry vision Enlarged lymph nodes Hacking cough Coughing blood Heart complications Liver enlargement Spleen enlargement Joint pain Arthritis Knee swelling Rashes Lupus pernio Erythema nodosum Skin lesions on back Subcutaneous nodules

Question 31

What causes sarcoidosis

Answer 31

Immune system overdrive

Question 32

Sarcoidosis clinicoradiographic data

Answer 32

Bilateral Hilary adenopathy in chest radiograph Lofgren syndrome

Question 33

Lofgren syndrome

Answer 33

Erythema nodosum rash & bilateral hilar adenopathy on CXR +/- fever + arthritis

Question 34

Parts of sarcoidosis diagnosis

Answer 34

Biopsy Clinicoradiographic data Exclusion of other diagnosis

Question 35

Sarcoidosis drugs

Answer 35

Corticosteroids Methotrexate Folic acid Azathoprine Leflunomide Mycophenolate

Question 36

Refractory sarcoidosis treatment

Answer 36

Infliximab

Question 37

Corticosteroid side effects

Answer 37

Osteoporosis Central adiposity

Question 38

How do corticosteroids improve cpsarcoidosis

Answer 38

Decrease pro inflammatory cell survival