Occupational Diseases Flashcards

1
Q

True or false: Tobacco smoking is the number #1 cause of preventable death in the US?

A

True

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2
Q

What fraction of smokers who continue to smoke will die from it?

A

1/2

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3
Q

What risk of developing lung cancer in about (__)x higher in male smokers, and (__)x higher in female smokers?

A

23x for males

13x for females

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4
Q

How many adults die d/t lung CA in the US each year as a result of second hand smoke?

A

3400

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5
Q

What is the most common occupational lung disease in the US?

A

asthma

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6
Q

What percent of adults in the US have a diagnosis of asthma?

A

7.5%

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7
Q

What is the best way to diagnose occupational asthma?

A

History–improvements over long breaks or weekends

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8
Q

What are the two types of occupational asthma?

A
  • Asthma with latency (immunologic)

- Without latency (Reactive airway dysfunction syndrome)

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9
Q

What test can you order to determine if a patient’s airway is reactive? What is the use of this with occupational asthma?

A

Methacholine challenge

Can see if there is hyperreactivity of the airway

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10
Q

What indicates a positive test in a methacholine challenge?

A

FEV1 drops by 20% at less than PD20

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11
Q

What are the objective tests for occupational asthma?

A

Pre and post shift monitoring of lung function (spirometry)

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12
Q

What percent of COPD is attributable to occupation?

A

15%

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13
Q

What are the common causes of occupational COPD?

A

Inorganic/organic dust exposure

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14
Q

What percent of E-cigs contain diacetyl or acetyl propionyl

A

75%

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15
Q

What is popcorn lung/flavorings lung disease?

A

Bronchiolitis obliterans caused by diacetyl (flavoring component of butter)

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16
Q

What is hypersensitivity pneumonitis?

A

A spectrum of granulomatous, interstitial, and alveolar filling lung diseases that result from repeated inhalation of and sensitization to a wide variety of organic dusts

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17
Q

What are the type of exposures that can lead to hypersensitivity pneumonitis?

A

Thermophilic bacteria
Fungal species
Birth feathers

18
Q

What type of immune reaction is hypersensitivity pneumonitis?

A

CD8 + influx of alveolar macrophages, with ill defined granuloma formation

19
Q

What are the ssx of hypersensitivity pneumonitis?

A

Sudden onset of fever, chills, malaise, cough, SOB.

Tachypnea and diffuse, fine crackles

20
Q

What might a CXR show with hypersensitivity pneumonitis?

A

Patchy, micronodular infiltrates

21
Q

What does ground glass appearance on imaging tell you, generally?

A

That the alveoli are affected

22
Q

What can chronic hypersensitivity pneumonitis lead to?

A

Pulmonary fibrosis and digital clubbing

23
Q

What are the three main types of pneumoconiosis?

A
  • Asbestosis
  • Silicosis
  • Coal dust
24
Q

What is pneumoconiosis?

A

Group of ILDs caused by the inhalation of certain dusts and the lungs reaction to it

25
Q

True or false: silicosis is associated with TB

A

True

26
Q

What are the radiological findings of silicosis?

A

Egg shell calcifications

27
Q

What are the histological findings of silicosis?

A

Alveolar filling with proteinaceous material

28
Q

What are the radiographic features of coal worker’s pneumoconiosis?

A

Similar to silicosis

29
Q

Where in the lung is asbestosis most commonly occur?

A

Pleura

30
Q

What is the latency period for asbestosis?

A

20-50 years

31
Q

What are the classic radiological findings of asbestosis?

A

Pleural plaques (diaphragmatic plaques)

32
Q

True or false: asbestosis can range from asymptomatic, to a debilitating restrictive lung disease

A

True

33
Q

How much more common is lung cancer in smokers with asbestosis?

A

50x

34
Q

What are the occupations that use Co-W carbide alloy? What disease does this cause?

A

Machine cutting tools

Parenchyma fibrosis

35
Q

What is the elemental gas that is associated with the development of lung cancer? What is this a breakdown product of?

A

Ra

Breakdown product of uranium and radium

36
Q

What is the cutoff limit for Ra gas to be considered safe?

A

4 piL

37
Q

What is the leading cause of death related to fires? How does this produce injury?

A

Smoke inhalation

Thermal injury to the upper airway, CO, CN

38
Q

What is the half life of CO with 100% O2 at 1 ATM? At 3 ATM?

A
  1. 3

23. 3

39
Q

At what level of COHb is hyperbaric O2 recommended?

A

25%

40
Q

What is the MOA of HCN?

A

Binds to Fe ions, like the cytochrome C, to block the respiratory cycle