Review Question - QID 109613

This patient is presenting with shortness of breath and a flow-volume loop demonstrating restrictive lung disease. Interstitial lung disease can cause this restrictive pattern of lung disease.

Interstitial lung disease presents with shortness of breath, crackles on physical exam, and a diffuse pattern of infiltration on chest radiography. A flow-volume loop will demonstrate decreased lung volumes and a sharper slope upward on inspiration. Though the FEV1/FVC ratio in these patients is normal/elevated, the absolute values of the FEV1 and FVC are decreased. Some common causes of interstitial lung disease include idiopathic pulmonary fibrosis, sarcoidosis, asbestosis, silicosis, and coal pneumoconiosis.

Figure A is demonstrating a flow volume loop that would be seen in restrictive disease (blue), a normal patient (green and dotted), and in obstructive disease (red). Illustration A is this same set of flow volume loops with labels.

Incorrect Answers:
Answers 1 & 4: Chronic obstructive pulmonary disease and poorly treated asthma presents with increased lung volumes on a flow-volume loop and a decreased slope upwards during inspiration. This is represented by the red flow volume loop.

Answer 2: Unstable angina presents with chest pain at rest; however, it would not present with abnormalities of the flow-volume loop.

Answer 5: Small cell carcinoma of the lung may present with shortness of breath, fatigue, and weight loss, but it would not present with a restrictive pattern of lung disease on a flow-volume loop.

Bullet Summary:
Restrictive lung disease presents on a flow-volume loop with decreased lung volumes and an increased slope on inspiration.