Interstitial Lung diseases, Part II, D Kinder, DSA Flashcards Preview

Year 2 Resp Exam 2 > Interstitial Lung diseases, Part II, D Kinder, DSA > Flashcards

Flashcards in Interstitial Lung diseases, Part II, D Kinder, DSA Deck (38):
1

Silicosis

fibrotic lung disease caused by inhalation of crystalline silica in form of quartz

2

What industries are at risk for silicosis

mining, tunneling, excavating, quarrying, stonework, foundries, sandblasting, ceramics

3

What are the categories of silicosis

chronic
accelerated
acute
progressive massive

4

what is hallmark pathology of chronic silicosis

silicotic nodule characterized by whorled hyalinized collagen fibers with more peripheral zone of dust laden macrophages
most common form of silicosis

5

describe acclereated silicosis

nodules develop after 3-10 yrs exposure
clinical course is progressive

6

describe acute silicosis

develops 6 mo-2 yrs post exposure
dyspnea, cough, weight loss and rapid progress to respiratory failure and death
alveolar filling process

7

What characterizes progressive massive fibrosis

lesions at least 1 cm in diameter and larger
lesions involve upper lobe
leads to resp failure, cor pulmonale, weight loss and death

8

what are associated diseases with silicosis

TB
COPD and chronic bronchitis
collagen vascular disease: RA and scleroderma
lung cancer

9

CXR silicosis

symmetric nodular pattern with upper lobes
hilar adenopathy with eggshell calcification

10

acute vs progressive massive silicosis on CXR

acute- air space and interstitial pattern
progressive- coalescence of nodules with larger mass lesions

11

PFT silicosis

normal ealry in chronic
later it is mixed pattern

12

Dx silicosis

based on Hx and characteristic X ray changes

13

management silicosis

irreversible
avoid further damage
TB testing
stop smoking

14

when do you consider lung transplants in silicosis

acute and accelerated

15

What causes coal workers pneumoconiosis CWP

deposits of coal dust in lung
increase with intensity of exposure and carbon content
anthracite is most toxic

16

patholgy CWP

coal macule with macrophages laden with coal dust in walls of respiratory bronchiles and adjacent alveoli
coal nodules
may have progressive massive fibrosis

17

clinical presentation CWP

no Sx or signs
can have Sx bronchitis
may lead to progressive massive fibrosis

18

assoc diseases with CWP

silicosis
scleroderma and RA
caplan

19

Caplan syndrome

RA with large cavitary pulmonary nodules assoc with silicosis and CWP

20

CXR of CWP

resembles silicosis
small rounded opacities in the lung parenchyma
can progress to progressie massive fibrosis with nodules 0.5 cm- 5 cm

21

PFT CWP

normal in early
often obstructive can have restrictive if fibrosis present
shown to lead to emphysema

22

Dx CWP

coal dust exposure
CXR

23

mangement CWP

avoid exposure
stop smoking

24

What is asbestosis

chronic fibrotic interstital lung disease secondary to prolonged inhalation of asbestos fibers
20 latency after exposure

25

industries at risk for asbestosis

mining, milling, transportation asbestos, building demolition, brake lining, ship building, insulations, fireproofing

26

What is unique pathologically to asbestosis

ferruginous bodies, asbestos bodies
sputum or BAL fluid

27

Signs and Sx asbestosis

signs: inspiratory crackles, clubbing
Sx: dyspnea, dry cough, chest tightness/pain

28

Assoc diseases of asbestosis

mesothelioma
lung cancer
pleural effusion

29

CXR asbestosis

pleural plaques
pleural effusion
pleural thickening
rounded atelectasis with "comet tail"
lower lobe and subpleural disease prominent

30

PFT asbestosis

restrictive
may be obstructive

31

Dx asbestosis

Hx exposure!!!!!
appropriate lag time exposure and disease
lung fibrosis on CXR or CT!!!!!!
restrictive PFT
b/l inspiratory crackles
clubbing

32

management asbestosis

no effective Tx
avoid exposure
stop smoking
lung transplantation

33

what industries are at higher risk beryllium disease

aerospace, electronics, ceramics, metal, nuclear, telecommunications, tool and die, welding

34

clinical presentation acute beryllium disease

acute pneumonitis: high exposure
cough, dyspnea, chest pain
blood tinged sputum and crackles

35

Sx chronic beryllium disease

dyspnea, cough, chest pain, lb loss, fatigue, arthralgias
similar to sarcoidosis ranging from asymptomatic to severe granulomatous restrictive lung disease
20 yrs post exposure

36

CXR beryllium disease

enlarged hilar or mediastinal nodes
or
multiple lung nodules
or
both
later: patchy fibrosis, hyperinflation and honeycombing

37

Dx beryllium disease

documented exposure to beryllium
evidence lung disease
positive BeLPT performed on blood or BAL fluid

38

management beryllium disease

avoid further exposure
stop smoking
steroids