What is the interstitium of the lung?
Connective tissue space around the airways and vessels and the space between the basement membranes of the alveolar walls
What is the connective tissue space around the airways and vessels called?
Interstitium of the lung
How are alveolar epithelial (pneumocytes) and interstitial capillary endothelial cell basement membranes in normal alveolar walls?
In direct contact
What does restrictive lung disease show?
Reduced lung compliance (stiff lungs)
Low FEV1 and low FVC but same FEV1/FVC ratio
Reduced gas transfer
What does the spirometry of restrictive lung disease look like?
What is the presentation of restrictive lung disease?
Abnormal chest X-ray
Dyspnoea (on exertion and rest))
Respiratory failure (type 1)
What is dyspnoea?
What is difficult breathing called?
What is the difference in chest X-rays between:
Restrictive lung disease
Emphysema can see all ribs
Normal can see 10 ribs
Restrictive lung disease can see less than 10
What is restrictive lung disease also known as?
Interstitial lung disease
What is the pathway leading to restrictive lung disease?
1) Lung injury
2) Leads to chronic response
3) One of usual interstitial pneumonitis (UIP), granulomatous response, or other pattens leads to
4) Fibrosis or end stage honeycomb lung
What does the acute response to lung injury lead to?
Diffuse alveolar damage
What is diffuse alveolar damage associated with?
Chemical injury/toxic inhalation
What does idiopathic mean?
No known cause
What is no known cause called?
What does the extend of diffuse alveolar damage depend on?
How many days the injury lasts for
What does DADS stand up for?
Diffuse alveolar damage
What are the histological features of acute alveolar damage?
Protein rich oedema
Denuded basement membranes
Why do granulomatous responses to chronic inflammation lead to fibrosis or end stage honeycomb lung?
What is sarcoidosis?
Multisystem granulomatous disorder of unknown aetiology
What is a multisystem granulomatous disorder of known aetiology?
What is the histopathology of sarcoidosis?
Epitheloid and giant cell granulomas
Necrosis/caseation very unusual
Little lymphoid infiltrate
Variable associated fibrosis
What is a granulomas?
Structure formed during inflammation that is found in many diseases, being a collection of macrophages
What is a structure formed during inflammation that is composed of a collection of macrophages?
What is the purpose of a granulomas?
Wall of a substance that cannot be destroyed
What is used to wall of a substance that cannot be destroyed?
Who does sarcoidosis commonly affect?
Does sarcoidosis affect more males or females?
What is the prevalence of sarcoidosis?
3-4/100,000 in UK
Where is sarcoidosis often common?