Restrictive lung disorders and pleura

Question 1

restrictive lung disorders

Answer 1

heterogeneous set of pulmonary disorders defined by restrictive patterns on spirometry

reduced distensibility of lungs
compromised lung expansion
reduced lung volume
reduced TLC

Question 2

causes of restrictive lung disease

Answer 2

plueral parenchyma disease
extrapulmonary disease- extrinsic

Question 3

pulmonary parenchyma disease intrinsic causes of restrictive lung disease

Answer 3

Idiopathic pulmonary fibrosis
systemic sclerosis
pulmonary vasculitis
radiation therapy
non-specific interstital pneumonia

Question 4

extrinsic extrapulmonary diseases

Answer 4

kyphoscolosis
pleural conditions e.g effusion, pleural scaring, chronic emphysema
neuromuscular disroders e.g dystrophy

Question 5

interstital lung diseases

Answer 5

inflammation or fibrosis of the lung that casues chronic mucous production

Question 6

causes of interstital lung disease

Answer 6

occupation/ environment- inhaled toxins
asbestosis

treatment- radiation

connective tissue disorder- RA

idiopathic- sarcoidosis

Question 7

clinical signs of interstital lung disease

Answer 7

dyspnoea
progressive breathless with exertion
haemoptysis
abnormal chest imaging

Question 8

occupational lung disease

Answer 8

inhalation of dust and fumes, smoke

causes- chronic bronchitis
pneumoconiosis
emphysema

Question 9

pneumoconiosis causes

Answer 9

REDUCED
TLC
functional residual capacity
residual volume

Reduced SPIROMETRY
decreased forced vital capacity

ABG
diffusion limitation

PFT
DLCO decreased
alveolar capilary damage

Question 10

asbestosis

Answer 10

fibres composed of hydrated magnesium silicates

causes pleural diseases

Question 11

pleural spaces

Answer 11

parital- lines chest cavity

visceral lines lungs

space for 5-15ml of fluid

Question 12

pneumothorax

Answer 12

air in pleural space

due to disruption to negative pressure in IPS, rupture of subpleural cyst. visceral pleura spererates from parital, air enters, collapse lung

Question 13

pleural effusion

Answer 13

pathologic collection of fluid and plus in pleural cavity

Question 14

causes of pleural effusion

Answer 14

trasudates- systemic factors alter pressure and fluid balance
exudates- caused by inflammation or injury to pleura
empyema attribution to infection
haemothorax
haemorrhagic plueral effusions

the pleural fluid rate exceeds lympatic removal

Question 15

haemothorax

Answer 15

collection of blood in pleural space

traumatic injury
aortic rupture
myocaridal rupture

Question 16

pathophysiology of haemothorax

Answer 16

bleeding into hemithorax from diaphragmatic,
the patient’s functional reserve, the volume of blood, and the rate of accumulation in the hemithorax.
Blood in the pleural space affects the functional vital capacity of the lung by creating alveolar
hypoventilation, V/Q mismatch, and anatomic shunting

Question 17

chest wall pathology affecting respirartory function

Answer 17

Kyphosis and scoliosis
* Ankylosing spondylitis
* Congenital and childhood abnormalities
* Obesity
* Traumatic and iatrogenic processes

Question 18

chest wall scoliosis

Answer 18

lateral displacement of the spine causes servere rib disortion

connective tissue disorders/ inflammatory condition
NMD

dyspnoea on exertion
rapid shallow breathing
thoracic cage deformity

Decreased TLC VC

Question 19

chest wall kyphosis

Answer 19

A/P angulation of the spine

serve rib disortion

trauma/ development probels

dyspnoea on exertion
rapid shallow breathing
chest wall deformed

decrease FVC

hypoxaemia

Question 20

scoliosis pathogenesis

Answer 20

paediatric-adolescent-adulthood development
* compression of growth plates
* asymmetric loading
* higher loads on chondrocytes (

Question 21

kyphosis pathogenesis

Answer 21

Vertebral compression fractures
* Low bone density
* Scheuermann’s disease
* Degenerative disc disease
* Postural changes

Question 22

chest wall ankylosing spondylitis

Answer 22

chronic inflammation of ligamentous insertion is sine or sacroiliac joints

lower back pain
limited flexibility of back and neck
stiffness of back

Question 23

ankylosing spondylitis pathogenesis

Answer 23

inflammatory process (tumour necrosis factor
- crucial role) affects articular processes,
costovertebral joints, sacroiliac joints
* induce a fibrotic response
* leads to joint calcification, ligament
ossification, and skeletal immobility

Question 24

ankylosing spondylitis pathophysiology

Answer 24

starts with inflammation at the entheses
* over time chronic inflammation causes bone
erosion and new bone formation
* can lead to fusion of vertebrae

Question 25

pathogenesis of obesity to chest wall

Answer 25

sustained positive energy balance (energy intake > energy expenditure) * resetting of the body weight “set point” at an increased value * impact of diet on obesity risk is explained largely by its effect on calorie intake. * habitual consumption of highly palatable and energy-dense diets predispose to excess weight gain irrespective of macronutrient content. * beyond diet, environmental factors confer obesity risk

Question 26

ABG with hypoventilation

Answer 26

hypoxaemia hypercapnia

Question 27

muscular dystrophies

Answer 27

progressive muscular weakness and wasting involvement of respiratory muscles

Question 28

GBS

Answer 28

progressive weakness and loss of motor function in respirtpry muscle