Restrictive (interstitial) Lung Diseases Flashcards

1
Q

What is the lung interstitium

A

The connective tissue space around the airways and vessels and is between the basement membranes of the alveolar wall

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2
Q

Features of Restrictive Diffuse Interstitial Lung Disease (4)

A

Reduced lung compliance
Low FEV1 and Low FVC but ratio is normal
Reduced gas transfer
Ventilation/Perfusion imbalance

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3
Q

Presentation of Diffuse Lung Disease (4)

A

Abnormal CXR
SOB on rest and exertion
Type 1 respiratory failure
Heart failure

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4
Q

Chronic Response (3)

A

Usual interstitial pneumonitis
Granulomatous
Fibrosis

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5
Q

Diffuse Alveolar Damage is Associated with (8)

A
Major Trauma
Chemical injury.toxic inhalation
Circulatory shock
Drugs
Infection
Autoimmune disease
Radiation
Idiopathic
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6
Q

Evolution of DAD (4)

A

Exudate stage
Oedema and hyaline membrane thickening
Proliferative stage
Interstitial inflammation and fibrosis

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7
Q

Histological features of DAD (7)

A
Protein rich oedema
Fibrin
Hyaline membranes
Denuded BM
Epithelial proliferation
Fibroblast proliferation
Scarring of interstitium and airspaces
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8
Q

What is Sarcoidosis

A

A multisystem granulomatous disorder of unknown aetiology

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9
Q

Histopathology of Sarcoidosis (4)

A

Epitheloid and giant cell granulomas
Necrosis/caseation very unusual
Little lymphoid infiltrate
Variable associated fibrosis

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10
Q

Who does Sarcoidosis normally effect (3)

A

Young people
F>M
People in temperature climates

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11
Q

Presentation of Sarcoidosis

A
Acute arthralgia 
Erythema nodosum
Bilateral hilar lymphadenopathy
SOB
Cough
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12
Q

Diagnosis of Sarcoidosis

A
Clinical findings
Imagine findings
Serum Ca++ and ACE
Bx
Kveim test
Tuberculin test
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13
Q

Causes of Hypersensitivity Pneumonitis (4)

A

Thermophilic actinomycetes
Bird/Animal proteins- faeces, bloom
Fungi
Chemicals

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14
Q

Thermophilic actinomycetes (2)

A

Micropolyspora faeni

Thermoactinmycetes vulgaris

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15
Q

Acute presentation of hypersensitivity pneumonitis (7)

A
Fever
Dry cough
Myalgia
Chills (4-9 hours)
Crackles, tachypnoea
Wheeze
Precipitating Ab
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16
Q

Chronic presentation of hypersensitivity pneumonitis (6)

A
Insidious
Malaise
SOB
Cough
Low grade illness
Can lead to respiratory failure
17
Q

Immune complex in Hypersensitivity Pneumonitis

A

Type III and Type IV

18
Q

Histopathology of Hypersensitivity Pneumonitis (6)

A
Immune complex
Soft centriacinar epithelioid granuloma
Interstitial pneumonitis 
Foamy histiocytes
Bronchiolitis obliterans
Upper zone disease
19
Q

Causes of Usual Interstitial Pneumonitis

A
Scleroderma
Rheumatoid disease
Drug reaction
Post infection
Asbestos exposure
Most are cryptogenic or Idiopathic
20
Q

Histopathology of UIP (6)

A
Patchy interstitial chronic inflammation
TYpe II pneumocyte hyperplasia
Smooth muscle and vascular proliferation
Temporal heterogeneity
Spatial heterogeneity
Proliferating Fibroblastic Foci
21
Q

Most common individuals who get Idiopathic Pulmonary Fibrosis

A

Elderly >50

M>F

22
Q

Clinical features of Idiopathic Pulmonary Fibrosis

A
Dyspnoea
Cough
Basal cracks
Cyanosis
Clubbing
23
Q

CXR of Idiopathic Pulmonary Fibrosis

A

Basal/Posterior
Diffuse Infiltrates
Cysts
Ground glass

24
Q

How can you correct Hypoxaemia caused by low V/Q

A

Increase FIO2

25
Q

CO2 diffuses _____ faster than O2 because

A

20 times

it has greater solubility

26
Q

What is a shunt

A

Blood passing from Right to Left side of Heart without contacting ventilated alveoli

27
Q

What do large shunts respond poorly yo

A

Increase in FIo2