Restrictive lung overview Flashcards
What are the clinical classifications of DPLD? (5 based on frequency, cause)
- Acute DPLD
- Episodic DPLD, may present acutely
- Chronic DPLD due to occupational/ environmental agent/drugs
- Chronic DPLD without systemic disease
- Chronic DPLD with systemic disease
What is restrictive lung disease?
Diseases that are extrinsic or intrinsic to the lungs that impairs alveolar gas exchange, leading to poor ventilation
Steps involved in the pathophysiology of Restrictive lung disease?
- Alveolar wall damage
- Impaired gas exchange
- C02 exchange unimpaired as it is v soluble
- Final effect–> Low PO2 (SO2) normal PCO2
Result- Poor ventilation
What happens to normal lung tissue in restrictive lung disease?
Pulmonary fibrosis- Normal lung tissue replaced by scar tissue, which have pockets of air in them
Honeycomb structure
What is pulmonary oedema?
Fluid in alveolar air spaces
What are the causes of cardiac PE?
Raised pulmonary venous pressure, due to LVF
What are non cardiac causes of PE?
Leaky pulmonary capillaries due to sepsis or trauma
What 3 things can cause consolidation of the air spaces leading to restrictive lung disease?
- Infective pneumonia
- Pulmonary emboli/infarct
- Other causes- e.g. rheumatoid
What kind of pathogens can cause pneumonia led consolidation?
Viruses- influenza,measles
Bacteria- TB, pneumococcus
Parasites- filaria
What is alveolitis?
Inflammatory infiltrate of the alveolar walls
What can cause alveolitis?
- Extrinsic allergic alevolitis
2. Sarcoidosis
What is sarcoidosis?
Inflammatory process characterised by granuloma formation in the lungs.
Two multi system effects of sarcoidosis?
- Lymphadenopathy
2. Erythema nodosum- red nodules appearing on leg shins
Give two examples of drugs that can cause Alveolitis?
- Bleomycin
2. Methatrexate
Which toxic gas can cause alveolitis?
Chlorine
What type of alveolitis can rheumatoid disease cause?
Fibrosing
Two examples of autoimmune disorders causing alveolitis?
Wegeners
Bechets
What is Pneumoconiosis?
Occupational restrictive disease caused by dust inhalation
Can be fibrinogenic as in asbestosis or non like in baritones
Clinical signs and symptoms of DPLD? (6)
1. Breathless on exertion 2 Cough but no wheeze 3. Finger clubbing 4. Inspiratory lung crackles 5. Central cyanosis 6. Pulmonary fibrosis- end stage response to chronic inflammation
What things are important in patient history to confirm DPLD? (4)
- Occupational
- Pets
- Drugs
- Arthritis (rheumatoid)
What are the lung volume findings that can confirm the diagnosis?
Reduced lung volumes
- Low FVC & FEV1
- FEV1/FVC normal
- Peak flow normal
What changes in saturation levels can confirm the diagnosis?
Low PO2 (SaO2), Normal PCO2 At rest or during exercise
