Restrictive Pulmonary Flashcards

1
Q

Pathologies that typically INTRINSICALLY restrict the ability of the lungs to expand are called

A

restrictive lung disease

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2
Q

Restrictive lung disease can be caused by:

A

increased stiffness of chest wall
weak muscles
damaged nerves

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3
Q

symptoms of Restrictive Lung Disease are:

A

shortness of breath
dry cough
reduced lung volume and TLC

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3
Q

symptoms of Restrictive Lung Disease are:

A

shortness of breath
dry cough
reduced lung volume and TLC

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4
Q

Restrictive Lung Disease is characterized by:

A

decrease in TLC
FEV1 remains unchanged
FEV1 –> FVC is preserved
Reduced lung compliance

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5
Q

What 2 conditions regarding O2 will most likely occur in an individual w RLD?

A

hypoxemia and hypoxia

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6
Q

Recite the hypoxemia levels in terms of PaO2 and SaO2 and what might look normal - severe.

A
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7
Q

What are external causes of restrictive lung disease?

A
  • kyphoscoliosis
  • pleural conditions such as effusion, pleural scarring
  • obesity
  • neuromuscular disorders
  • ascites
  • rib cage deformation
  • neurological pathologies limiting activation of resp. muscles
  • reduced ability of the diaphragm to descend.
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8
Q

What is pickwickian syndrome?

A

a conditon consisting of hypoventilation, daytime hypercapnia and daytime hypoxemia in an obese pt with a sleep disorder in the absence of other causes of hypoventilation such as COPD

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9
Q

what are the 3 conditions an individual with Pickwickian syndrome will have?

A

hypoventilation
daytime hypercapnia
daytime hypoxemia

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10
Q

What are the internal causes of RLD?

A

destruction or scarring of lung parenchyma
idiopathic fibrotic disease
connective tissue diseases
drug-induced lung disease
environmental exposure
sarcoidosis

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11
Q

Describe the process of developing RLD.

A

Inflammation →
recruitment of fibroblasts→
pulmonary fibrosis →
sclerotic injury/ abnormal hardening of the alveolar wall → reduced ability to expand/ sclerotic injury creates a physical barrier to gas exchange →
↓DLCO (diffusing capacity for carbon monoxide) and
↓ the ability of the alveoli to expand

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12
Q

What is sarcoidosis?

A

disease characterized by the presence of granulomas or tiny clusters of WBC and other tissues in response to chronic inflammation.

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13
Q

What are the complications of restrictive lung disease?

A
  • hypoxemia (reduce PaO2)
  • Compensated for by inc. respiration rate
  • increased energy expenditure by respiratory muscles that may lead to muscle wasting and weight loss
  • chronic respiratory failure
  • pulmonary hypotension and cor pulmonale
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14
Q

Use TLC levels to classify each stage of RLD.

Restrictive disease:
mild restrictive disease:
moderate restrictive disease:
moderately severe restrictive disease:
severe restrictive disease:

A

Restrictive disease: <80%
mild restrictive disease: 70 - 80%
moderate restrictive disease: 60 - 70%
moderately severe restrictive disease: 50 - 60%
severe restrictive disease: <50%

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15
Q

During a physical examination, how might we tell if someone has restrictive lung disease?

A

velcro crackles in lungs
inspiratory squeaks
gurgling during inspiration/expiration
cyanosis
Digital clubbing

16
Q

What is a cardiac dysfunction of RLD?

A

Cor pulmonale

17
Q

What condition has a median survival rate of 3 - 5 years after diagnosis?

A

Interstitial pulmonary fibrosis

18
Q

what condition has a 70% mortality rate in 3 months and will lead to acute respiratory distress syndrome?

A

acute interstitial pneumonia

19
Q

What is included in medical management of RLD?

A

symptom management
corticosteroids
anti-inflammatories
adequate oxygenation
surgery
heart-lung transplant

20
Q

What is a pneumoconiosis?

A

a lung disease caused by breathing in certain kinds of dust particles that damage your lungs.

21
Q

What is another name for a pneumoconiosis?

A

occupational lung disease

22
Q

Is lung scarring reversible?

A

NO

23
Q

What are the types of interstitial lung disease?

A

Exposure related (drug induced/ occupational)
autoimmune related
idiopathic

24
Q

How do we treat chronic interstitial disease?

A

medications (corticosteroids, theophylline, inhalable cromolyn sodium)
treat complications
chest physiology (remove secretions)
exercise

25
Q

What are the 3 types of interstitial lung disease?

A

exposure related
autoimmune
idiopathic

26
Q

This chronic interstitial disease is characterized by inflammation, scarring, and fibrosis

A

pneumoconiosis

27
Q

What are examples of pneumonconiosis?

A

black lung disease
brown lung disease
asbestoses
silicosis

28
Q

What is decreased secondary to increased lung stiffness/decreased lung compliance?

A

static lung volumes
number of alveoli

29
Q

What other chest wall disorder result in restrictive lung diseases?

A

neuromuscular
skeletal deformities
post surgical status
obesity
collagen vascular diseases

30
Q

What are causes of Idiopathic pulmonary fibrosis?

A

environment
cigarettes
genetic factors
age >50

31
Q

With idiopathic pulmonary fibrosis, what side effects occur a
Restrictive disease:
mild restrictive disease:
moderate restrictive disease:
moderately severe restrictive disease:
severe restrictive disease:fter the insidious onset?

A

Hypoxemia, cyanosis, clubbing

32
Q

What are common chest wall disorder associated with RLD?

A

neuromuscular (ALS, Polio, MD, Guillain - Barre)
Skeletal deformity (kyphosis, scoliosis, chest wall injury)

33
Q

What are common post surgery statuses associated with RLD?

A

abdominal and thoracic surgery after obesity and collagen vascular diseases

34
Q

Do people with RA experience pulmonary issues?

A

yes

35
Q

Diffusion of interstitial fibrosis occurs in which condition:

A

Systemic sclerosis (scleroderma)

36
Q

What percentage of people w lupus experience pulmonary issues?

A

50%

37
Q

What is a common pulmonary issue amongst those with systemic lupus?

A

pleuritis (pleural cavity inflammation)
pneumonitis (lung tissue inflammation)
pulmonary hypertension

38
Q

Is pneumonitis serious? why or why not?

A

yes, it can cause the lungs to scar