Restrictive Lung Disease

Question 1

what is a common exposure for small airways disease?

Answer 1

smoke pits…tour in afghanistan

Question 2

what does small airways disease…obstructive or restrictive airway disease?

Answer 2

obstructive…anything with the airways is always obstructive

Question 3

name three ways to effect the chest wall and restrict it

Answer 3

mordib obesity
kyphoscoliosis
fibrothorax

Question 4

name four things that cause weakness of respiratory muscles

Answer 4

polia
myasthenia gravis
guillian baree
amyotrophic lateral sclerosis (ALS)

Question 5

name two things that cause abnormalities of lung parenchyma

Answer 5

sarcoidosis

idiopathic pulmonary fibrosis

Question 6

how does ILD affect TLC, FRC and RV?

Answer 6

they are all decreased

Question 7

how does muscle weakness affect TLC, FRC and RV?

Answer 7

TLC decreased FRC normal and RV increased

Question 8

how does obesity affect TLC, FRC, and RV?

Answer 8

TLC slightly reduced or normal
FRC REDUCED
RV normal

Question 9

what is the tip off lung volume change for obesity?

Answer 9

reduced FRC

Question 10

what is another name for interstitial lung disease?

Answer 10

diffuse parnehcymal Lung disease

Question 11

in restrictive disease…does compliance increase of decrease?

Answer 11

decreased!!

Question 12

how does ILD affect the FVC?

Answer 12

it lowers it

Question 13

how does ratio of FEV1/FVC change in ILD?

Answer 13

it will be normal or high

Question 14

how does ILD affect DLCO?

Answer 14

it takes longer for the oxygen to diffuse..so DLCO is decreased compared to normal

Question 15

what are two common signs of cor pulmonale?

Answer 15

jugular venous distension

peripheral edema

Question 16

what is the most common disease that mimics ILD?

Answer 16

congestive heart failure

Question 17

is silicosis an upper or lower lobe disease?

Answer 17

upper lobe

Question 18

what does silicosis cause?

Answer 18

calcification in the upper love

Question 19

is asbestosis an upper or lower lobe lung disease?

Answer 19

lower lobe disease

Question 20

what is a histological finding in asbestosis?

Answer 20

ferruganous bodies, iron deposits

Question 21

is coal worker pneumoconiosis an upper or lower lobe disease?

Answer 21

upper lobe

Question 22

what is the gold standard imaging for ILD?

Answer 22

high resolution CT

Question 23

what does ground glass on a CT suggest in ILD?

Answer 23

active inflammation

Question 24

what CT finding does diffuse alveolar hemorrhage?

Answer 24

ground glass…due to bloody

Question 25

is IPF in lower or upper lobes?

Answer 25

lower lobes..

Question 26

what ILD does clubbing signal?

Answer 26

IPF

Question 27

explain the disease mechanism in IPF

Answer 27

injury to epithelium causes cytokine release that activates myofibroblasts instead of epithelial recovery..leads to collagen deposition

Question 28

what does it mean for granuloma to be non caseating?

Answer 28

no necrotizing in the middle of the granuloma

Question 29

what cells make up the granuloma in sarcoid?

Answer 29

macrophages, histiocytes, lymphocytes and dendritic cells

Question 30

what cytokines are associated with sarcoidosis? what T cell?

Answer 30

IFN-gamma IL2 IL12 Th1

Question 31

is sarcoidosis caused by antigens or nah?

Answer 31

questionable...maybe non TB myco in US

Question 32

after development of granulomas in saroidosis...what can happen to them?

Answer 32

can either self resolve or progress to fibrotic tissue

Question 33

is sarcoidosis an upper or lower lobe disease?

Answer 33

upper lobe

Question 34

how to diagnose sarcoidosis?

Answer 34

bronchoscopy...must have proof of granulomas

Question 35

what two things must you see to diagnose Sarcoid?

Answer 35

granulomas | no evidence of cancer, infection with TB or fungus

Question 36

what are cutaneous granulomas called in sarcoid?

Answer 36

lupus pernio

Question 37

name a kidney finding with sarcoidosis?

Answer 37

hypercalcemia leading to nodules in the kidney

Question 38

what molecule leads to hypercalcemia in sarcoid?

Answer 38

alpha 1 hydroxylase

Question 39

name three common causes of diffuse alveolar hemorrhage

Answer 39

goodpasture syndrome microscopic polyangitis granulomatous with polyangitis

Question 40

what two molecules associated with kidneys are elevated in sarcoidosis?

Answer 40

ACE and Calcium

Question 41

what are the four stages of sarcoidosis?

Answer 41

1-lymphadenopathy hilar 2/3- lung parenchyma involvement 4- fibrosis

Question 42

what is the treatment for sarcoidosis? when should it be initiated?

Answer 42

corticosteroids when symptomatic