Restrictive Thoracic Disease Flashcards Preview

Respiratory > Restrictive Thoracic Disease > Flashcards

Flashcards in Restrictive Thoracic Disease Deck (21)
Loading flashcards...
1
Q

What are the skeletal problems that can cause thoracic restriction?

A

Vertebrae - thoracic kyphoscoliosis, ankolosing spondylitis

Ribs - traumatic rib fracture

2
Q

What are the muscle weakness problems that can cause thoracic restriction?

A

Intercostal or diaaphragmatic weakness

myopathy, neuropathy, myelopathy

3
Q

What are the abdominal problems that can cause thoracic restriction?

A

Obesity

Ascites

4
Q

What do thoracic problems that originate from outwith the thoracic region result in?

A

Chronic alveolar under ventilation with a low PaO2 and a secreased SaO2, normal or low PaCO2 and reduced lung volume

5
Q

What are thoracic restrictions that result due to causes within the lungs?

A

Acute diffuse parenchymal lung disease (DLPD) is a group of lung diseases that affects the interstitium. Concerns alveolar epithelium, pulmonary capillary endothelium, basement membrane, perivasclar and perilymphatic tissues
Episodic DPLD
Chronic DLPD due to occupational or environmental agents/drugs
Chronic DLPD with evidence of systemic disease
Chronic DPLD with no evidence of systemic disease

6
Q

What is DLPD?

A

Disease of alveolar structures such as the alveolar walls and lumen (lung parenchyma)

7
Q

What is the pathophysiology of DLPD?

A

Impaired alveolar gas exchange
Alveolar barrier to oxygen exchange
CO2 exchange unimpaired as alveolar ventilaiton is normal
Decreased PaO2 and SaO2 and normal PaCO2

8
Q

What are the causes of DLPD?

A

Fluid in the alveolar space
Cardiac pulmonary oedema in alveolar walls and lumen due to raised pulmonary venous pressure
Non-cardiac pulmonary oedema - normal pulmonary venous pressure with leaky pulmonary capillaries due to sepssi or trauma

9
Q

What causes infective pneumonia?

A

Viral (Influenze, measles, chickenpox) bacteria (Pneumococcus, TB), fungal (HIV/pneumocystis), parasites (toxacara, filaris)

10
Q

What causes infarction?

A

PE, vasculitis

11
Q

What is BOOP?

A

Bronchiolitis obliterans organizing pneumonia

12
Q

What are other causes of restrictive lung disease?

A

Rheumatoid disease
Drugs
Cryptogenic

13
Q

What are allergic causes of alveolitis?

A

Farmers lung

Avian (birds)

14
Q

What is sarcoidosis?

A

Multi-system disease
Lymphadenoathy
Erythema nodosum

15
Q

What drugs/toxic gas that can induce alveolitis?

A

Amiodarone
Gold
Blemocycin
Chlorine

16
Q

What are autoimmune diseases that can cause alveolitis?

A

SLE
Polyarteritis
Wegners
Churg-strauss

17
Q

What are dust-diseases that can cause alveolitis?

A

Fibrogenic - asbestos/silicosis

Non-fibrogenic - siderosis (iron), stenosis (tin), baritosis (barium)

18
Q

What are carcinomas that can cause alveolitis?

A

Lymphatic/blood spread

Adenoa - bronchus, breast, prostate, colon, stomach

19
Q

What is the clinical syndrome of DLPD?

A
Breathless of exertion 
Cough but no wheeze 
Finger Clubbing 
Inspiratory lung crackles 
Central cyanosis 
Pulmonary fibrosis occurs at end stage response to chronic inflammation
20
Q

How is DPLD diagnosed?

A

History - occupation, drugs, pets, arthiritis
Reduced lung volumes - decreased FEV1, FVC but normal ratio of above 75%
Reduced gas diffusion (DLCO)
Arterial oxygen desaturation at rest or on exercise
Antibodies
Bilateral diffuse alveolar infiltrates on CXR
Echocardiogram to exclude heart failure
High resultion CT to identify inflammatory ground glass vs fibrotic nodular component of alveolar infiltrates in IPF
Breonchoalveolar lavage or induced sputum
Transbronchial or thorascopic lung biopsy

21
Q

What is the treatment of restrictive lung disease?

A

Remove trigger factor
Treat reversible alveolitis i.e. ground glass on high resolution CT
Oxygen in hypoxemic
Treatment of secondary pulmonary hypertension
Lung transplant