All are decreased in infiltrative lung disease except
**Core Concept**
Infiltrative lung diseases, such as interstitial lung disease (ILD), are characterized by the accumulation of inflammatory cells, fibrosis, and/or edema within the lung parenchyma. This leads to impaired gas exchange and decreased lung function. Key physiological parameters affected in ILD include lung volumes, diffusing capacity, and compliance.
**Why the Correct Answer is Right**
The correct answer is related to the fact that infiltrative lung disease typically involves the accumulation of inflammatory cells, fibrosis, and/or edema within the lung parenchyma, leading to impaired gas exchange and decreased lung function. Lung volumes, particularly total lung capacity (TLC) and residual volume (RV), are often decreased due to the restrictive nature of the disease. However, the diffusing capacity for carbon monoxide (DLCO) is typically decreased due to the destruction of the alveolar-capillary membrane. Compliance, on the other hand, is often increased in infiltrative lung disease due to the loss of elastic recoil and the accumulation of fibrotic tissue, which can make the lungs overexpand.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because the diffusing capacity for carbon monoxide (DLCO) is typically decreased in infiltrative lung disease due to the destruction of the alveolar-capillary membrane.
**Option C:** This option is incorrect because lung compliance is often increased in infiltrative lung disease due to the loss of elastic recoil and the accumulation of fibrotic tissue.
**Clinical Pearl / High-Yield Fact**
Infiltrative lung diseases often present with a restrictive pattern on pulmonary function tests, characterized by decreased lung volumes and a decreased diffusing capacity. However, the key to distinguishing between different types of ILD is to measure the rate of decline in lung function over time.
**Correct Answer: D. Compliance. Increased compliance is a characteristic feature of infiltrative lung disease.**