Restrictive Lung Diseases Flashcards
(23 cards)
Cause of restriction for restrictive lung diseases
Interstitial Lung Diseases
The lung cannot open/ expansion of the lung is restricted
Intrensic: Alteration of lung parynchyma
Extrensic: Alteration of pleura, chest wall, or neuromuscular apparatus
What is the interstitial tissue
Parymchyma
Tissue between alveolar epithelium and pulmonary capillary endothelium
Extrensic restrictive lung diseases
Diseases of pleura: Pneumothorax, pleural effusion
Disease of chest wall: Scoliosis, Pectus excavatum, obesity, Neuromuscular disorders
What happens to vital capacity and lung capacity in restrictive dises
Reduced vital capacity, reduced lung compliance.
Small TLC
Reduced Diffusion/DLCO
FEV1 and FVC are reduced, so Ratio is same or may rise. The ratio itself does not say the severity of the disease because both FEV1 and FVC decrease
Intrensic causes of ILD
- Idiopathic pulmonary fibrosis
- Sarcoidosis
- Hypersensitivity pneumonitis
- Drugs (Amioderone, notrofurantoin), Radiation
- Pneumoconiosis
- Scleroderma
Key hallmark of ABGs in ILD
Hypoxia
Reduced lung compliance and volume leads to V/Q mismatch, decreased diffusion of gasses, Decreased DLCO (diffusion)
ILD history of patient
- Insidious progression of Dyspnea, worse during exercise
- Dry, nonproductive cough
- Clubbing of nails, Coarse crackles
CXR of ILD shows what
Reticular pattern
Ground glass opasities
Bilateral hilar enlargement (Sarcoidosis)
CT of ILD shows what
Honeycombing apperance
Ground glass
Cause of pneumoconiosis
Dust inhallation causes parynchymal lung disease
Tissue undergoes fibrosis
Black lung pneumoconiosis is caused by what
Coal worker’s Pneumocoinosis, coal sourrounds bronchioles.
Cough, dyspnea, respiratory failure
Silicosis
- Silica during mining, sandblasting
Asbestos causes what diseas
mesothelioma
Asbestos fibers penetrate into lung
Causes Pneumocoinosis
Sx of asbestosis
Type of pneumocoinosis
Dyspnea, weakness, clubbing, CRACKLES
Sarcoidosis on imaging
Bilateral lymphadenopathy (hilar)
Reticular opasities
Pulmonary fibrosis
Tx for sarcoidosis
No tx, disease enters remission, typically self-limiting
Corticosteroids 4-12 weeks, Methotrexate
Lung transplant
Presentation of sarcoidosis
Dyspnea, dry cough, fatigue.
Derm symptoms(nodules and rash)
Extrapulmonary causes of Restrictive lung diseases
Bony deformities cause restrictive disease (Scoliosis) leads to dyspnea and hypoxemia, CO2 retention
Ankylosing spondylisis
What type of disease does ankylosing spondylitis cause
Extrapulmonary restrictive lung disease
Kyphosis
Decreased lung compliance
Cause arthritis of sacroiliac joint. Decreased lung compliance, but respiratory failure doesn’t occur
Autoimmune
Neuromuscular disorders that effect chest wall and cause restrictive lung dx
Gullian-Barre syndrome
Myasthenia Gravis
Botulism
Muscular dystrophy
Polio
ALS
Depression of respiratory center by drugs (opioids)
Disease of madulla
Spinal cord injury
Nerve to respiratory muscle disease (Gullian barre)
NMJ dx (Myasthenia gravis)
Upper airway obstruction (tracheal compression)
Describe Cryptogenic organizing pneumonia
ILD where bronchi and alveoli become inflamed, leading to flu-like illnesses
Bronchioloitis Obliterans
Many different causes, including infection, rheumatologic, AMIODERONE
Tx of cryptogenic Organizing pneumonia (Bronchiolitis obliterans)
Corticosteroids
Azithromycin/Clarithro
Azathioprine/Cellcept
When does radiation pneumonitis arise following radiation
3-12 weeks after
Dry cough, dyspnea, fever, weight loss
Corticosteroids for tx
