Respiratory Diseases and Disorders
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Questions and Answers

What is the main function of the respiratory system?

  • Filtering of blood
  • Regulation of blood pressure
  • Addition of O2 and removal of CO2 from the circulating blood (correct)
  • Storage of nutrients
  • What is the characteristic feature of desquamative interstitial pneumonia?

  • Diffuse fibrosis
  • Patchy thickening of alveolar walls
  • Alveoli filled by macrophages with minimal fibrosis (correct)
  • Progressive fibrosis with architectural abnormalities
  • What is the final stage of idiopathic pulmonary fibrosis?

  • Interstitial inflammatory infiltration by mixed inflammatory cells
  • Interstitial fibroblastic proliferation
  • Progressive obliterative fibrosis with architectural abnormalities (correct)
  • Alveolar exudation with edema
  • What is the prognosis of desquamative interstitial pneumonia?

    <p>Good</p> Signup and view all the answers

    What is the definition of respiratory failure?

    <p>Hypoxemia with arterial oxygen tension below 60 mmHg</p> Signup and view all the answers

    What is the characteristic feature of usual interstitial pneumonia?

    <p>Patchy thickening of alveolar walls due to fibrosis and mixed inflammation</p> Signup and view all the answers

    What is the primary cause of idiopathic pulmonary fibrosis?

    <p>Unknown</p> Signup and view all the answers

    What is the complication of repeated exposure to idiopathic pulmonary fibrosis?

    <p>Lung fibrosis and end-stage honeycomb lung</p> Signup and view all the answers

    What is the characteristic feature of the second stage of idiopathic pulmonary fibrosis?

    <p>Interstitial inflammatory infiltration by mixed inflammatory cells</p> Signup and view all the answers

    What is the clinical presentation of idiopathic pulmonary fibrosis?

    <p>Episodes of fever, malaise, dyspnea, and basal crepitations</p> Signup and view all the answers

    Study Notes

    Restrictive Pulmonary Disease

    • Reduced lung parenchyma expansion due to thoracic cage abnormalities (neuromuscular problems, severe obesity, kyphoscoliosis) or intrinsic pulmonary causes (interstitial lung disease)

    Causes of Restrictive Lung Disease

    • Idiopathic interstitial fibrosis (most common)
    • Occupational and environmental dust (coal, silica, asbestos, organic dust)
    • Post-infectious
    • Drugs and toxins
    • Ionizing radiation, sarcoidosis, connective tissue diseases

    Clinical Picture of Restrictive Lung Disease

    • Progressive breathlessness
    • Non-productive cough
    • Chest X-ray shows patchy opacities in basal areas

    Acute Respiratory Distress Syndrome (ARDS) and Acute Lung Injury (DAD)

    • Final common pathway for severe lung injuries
    • Hyaline membranes lining alveoli in early DAD
    • Interstitial inflammation and fibrosis
    • High oxygen tensions needed to treat hypoxia, which can potentiate the disease

    Pneumoconiosis

    • Group of lung diseases resulting from inhalation of organic or inorganic dust
    • Honeycomb lung is the end stage of most pneumoconiosis
    • Factors determining type and extent of damage: physical and chemical properties of inhaled dust, concentration, duration of exposure, coexistence of other lung diseases

    Coal Workers' Pneumoconiosis

    • Inhalation of coal with low silica content
    • Two stages: simple pneumoconiosis and progressive massive fibrosis
    • Simple pneumoconiosis: dust particles engulfed by macrophages, local fibrotic reaction, obliteration of peribronchial alveoli and atrophy of bronchial smooth muscle
    • Progressive massive fibrosis: massive confluent fibrosis of upper lobes, 10-20 years following exposure

    Silicosis

    • Inhalation of silica particles
    • Engulfment by macrophages
    • Discrete grayish-black fibrotic nodules
    • Refractile silica particles surrounded by rings of fibrosis
    • Obliteration of lumena of bronchioles and blood vessels with pleural adhesions

    Asbestosis

    • Inhalation of asbestos particles
    • Asbestos is a carcinogenic agent, predisposing to mesothelioma
    • Most famous types: white asbestos (chrysotile), blue asbestos (crocidolite), brown asbestos (amosite)
    • Associated with building industry, shipping, and motor engine industry
    • Amount of asbestos inhaled is the most important factor
    • Fibers partially or completely engulfed by macrophages, coated by iron and proteins, appearing as drum sticks

    Complications of Pneumoconiosis

    • Secondary T.B (except asbestosis)
    • Respiratory failure
    • Right heart hypertrophy and failure

    Extrinsic Allergic Alveolitis

    • Due to inhalation of organic dust, causing local Arthus reaction (type III hypersensitivity reaction)
    • Examples: Farmers' lung and Bird fancier's disease
    • Clinically presents as episodes of fever, malaise, dyspnea, and basal crepitations
    • Repeated exposure may induce lung fibrosis and end-stage honeycomb lung

    Idiopathic Pulmonary Fibrosis

    • Diagnosis by exclusion of other causes like extrinsic allergic alveolitis and pneumoconiosis
    • Occurs in stages: alveolar exudation, interstitial inflammatory infiltration, interstitial fibroblastic proliferation, and progressive obliterative fibrosis
    • Two forms: usual interstitial pneumonia and desquamative interstitial pneumonia

    Respiratory Failure

    • Defined as hypoxemia with arterial oxygen tension <60 mmHg
    • Addition of O2 and removal of CO2 from circulating blood is the main function of the respiratory system

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    Description

    Learn about restrictive pulmonary diseases, respiratory failure, pneumoconiosis, and idiopathic pulmonary fibrosis, including causes and effects on the lung parenchyma and thoracic cage.

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