Restrictive lung disease

Question 1

Restricted lung disease - volumes

Answer 1

1. decreased FVC

2. decreased TLC

Question 2

Restricted lung disease - pulmonary function test

Answer 2

FEV1/FVC >= 80%

Question 3

Restricted lung disease - types

Answer 3

1. poor brbeathing mechanics

2. Interstitial lung diseases

Question 4

Restricted lung disease - poor breathing mechanics properties

Answer 4

1. extrapulmonary
2. peripheral hypoventilation
3. normal A-a gradient

Question 5

Restricted lung disease - Interstitial lung disease properties

Answer 5

1. decreased pulmonary diffusing capacity

2. increased A-a gradient

Question 6

Restricted lung disease - poor breathing mechanics –> situations (and causes)

Answer 6

1. poor muscular effort (polio, myasthenia gravis)

2. poor structural apparatus (scoliosis, morbid obesity)

Question 7

Restricted lung disease - causes of poor muscular effort

Answer 7

1. polio

2. myasthenia gravis

Question 8

Restricted lung disease - causes of poor structural apparatus

Answer 8

1. scoliosis

2. morbid obesity

Question 9

Langerhans cell histiocytosis - also called

Answer 9

eosinophilic granuloma

Question 10

Restricted lung disease - drug toxicity

Answer 10

1. bleomycin 2. busulfan

3. amiodarone 4. methotrexate

Question 11

idiopathic pulmonary fibrosis - pathophysiology

Answer 11

repeated cycles of lung injury and wound healing with increased collagen deposition

Question 12

sarcoidosis images and histology

Answer 12

1. bilateral hilar lymphadenopathy

2. noncaseating granuloma in multiple organs

Question 13

sarcoidosis - ‘‘paraneoplastic’’

Answer 13

1. elevated serum ACE

2. hypercalcemia

Question 14

sarcoidosis - pathophysiology of hypercalcemia

Answer 14

1‐α hydroxylase activity of epithelioid histiocytes converts vitamin D to its active form

Question 15

Restricted lung disease - causes of interstitial lung capacity (10)

Answer 15

1. ARDS 2. NRDS 3. Pneumoconioses 4. Sarcoidosis 5. idiopathic pulm fibrosis 6. Goodpasture 7. Wegener
2. Eosinophilic granuloma 9. hypersensitive pneumonitis
3. drugs

Question 16

Idiopathic pulmonary fibrosis - mechanism

Answer 16

repeated cycles of lung injury and wound healing with increased collagen deposition

Question 17

Idiopathic pulmonary fibrosis - histology

Answer 17

honeycomb

Question 18

Idiopathic pulmonary fibrosis - special characteristic in clinical presentation

Answer 18

digital clubbing

Question 19

normal FEV1/FVC

Answer 19

80%

Question 20

obstructive FEV1/FVC

Answer 20

less than 80%

Question 21

restrictive FEV1/FVC

Answer 21

more than 80%

Question 22

obstructive lung volumes

Answer 22

increased TLC FRC RV

Question 23

restrictive vs obstructive according FEV1

Answer 23

obstructive: FEV1 is MORE dramatically reduced compared to FVC
restrictive: FEV1 is LESS dramatically reduced compared to FCV

Question 24

restrictive vs obstructive according FEV1

Answer 24

obstructive: FEV1 is MORE dramatically reduced compared to FVC
restrictive: FEV1 is LESS dramatically reduced compared to FCV

Question 25

restrictive vs obstructive according spirometry loop

Answer 25

obstructive --> loop shifts to the left | restrictive --> loop shifts to the right