restrictive lung disease

Question 1

def. restrictive lung disease

Answer 1

disease that reduces the size of the lung (TLC)

- TLC

Question 2

3 possible cause

Answer 2

1. interstitial lung disease (parenchymal)
2. chest wall restriction (extraparrenchymal)
3. neuromuscular (extra)

Question 3

what is ILD

Answer 3

disease that increases the thickness of alveolar membranes

Question 4

2 effects of ILD

Answer 4

1. increased stiffness of lung

2. reduced diffusion across alveoli

Question 5

4 steps to dx ILD

Answer 5

1. Hx
2. Phx
3. CXR with interstitial changes
4. PFT - parenchymal restriction

Question 6

what is seen on CXR

Answer 6

reticulations and nodularity

Question 7

what is seen on PFT for ILD

Answer 7

reduced TLC

• proportional reduction in FEV1 and FVC
• both reduced, but FEV/FVC is normal

Question 8

what is seen in DLCO in ILD

Answer 8

reduced - can’t get O2 across

Question 9

what is chest wall restriciton

Answer 9

squeezing of the chest wall from the outside

Question 10

3 possible cause of chest wall restrciotn

Answer 10

1. obesity
2. bony abnormalities
3. pleural disease

Question 11

what is important measurement for bony abnormalities

Answer 11

cobb angle
>60 - associated with lung restriciton
>100 - can lead to resp. failure

Question 12

2 types of pleural disease

Answer 12

1. effusion

2. calcifications

Question 13

what is seen in PFT of chest wall restriction

Answer 13

1. TLC

Question 14

4 regions that can cause a neuromuscular disease of lung

Answer 14

1. C-spine 3,4,5
   - mech
   - ischemic
   - inflammatory
2. phrenic nerve
   - trauma
   - inschemic
3. NMJ
   - myasthenia
4. diaphragmatic muscle disease

Question 15

how to make a diagnosis of neuromusc (5)

Answer 15

1. Hx
2. PHx
3. abdominal paradox
4. PFT - same as mechanical
5. tests of resp. muscle strenght

Question 16

2 tests for resp muscle strenght

Answer 16

1. MIPs/MEP
   - max inspiritory and expiratory pressures
   -