Occupational lung diseases, D Kinder, DSA Flashcards Preview

Year 2 Resp Exam 2 > Occupational lung diseases, D Kinder, DSA > Flashcards

Flashcards in Occupational lung diseases, D Kinder, DSA Deck (38):
1

silicosis

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

2

What industries are at risk for silicosis

mining, tunneling, excavating, quarrying, stonework, foundries, sandblasting, ceramics and stressed denim jean manufacturing

3

Most common form and presentation of silicosis

chronic silicosis: silicotic nodule characterized by whorled hyalinized collagen fibers with a more peripheral zone of dust laden macrophages
may be asymptomatic or complain of dyspnea. productive cough

4

What is accelerated silicosis

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

5

what is acute silicosis

6 mo-2 yrs after massive exposure
Sx: dyspnea, cough, wheezing and weight loss that rapidly progresses to respiraotry failure and death

6

what is progressive massive fibrosis from silicosis

lesions at least 1 cm in diameter, often larger and usually involve the upper lobes
leads to respiratory failure, cor pulmonale, weight loss and death

7

What are some diseases associated with silicosis

TB
COPD and chronic bronchitis
Collagen vascular disease: RA and scleroderma
Lung cancer

8

what will a CXR show with silicosis

symmetric nodular pattern involving upper lobes
hilar adenopathy with eggshell calcidication is strongly suggestive
progressive massive fibrosis characterized by coalescence of the nodules with larger mass lesions
acute will show air space and interstitial pattern on x ray

9

What will silicosis show on PFT

normal early in chronic silicosis, later mixed pattern obstructive and restrictive

10

Dx of silicosis

based on Hx and characteristic CXR changes

11

management of silicosis

disease is irreversible
TB testing
stop smoking
consider lung transplants in acute and acclerated silicosis

12

Coal Workers Pneumoconiosis

deposits of coal dust in lung, increases with intensity of exposure and carbon content

13

msot toxic component of coal dust

anthracite

14

pathology of coal pneumoconiosis

coal macule of macrophages laden with coal dust in the walls of respiratory bronchioles and adjacent alveoli
coal nodules
progressive massive fibrosis may be seen

15

What is clinical presentation of coal workers pneumoconiosis

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

16

What are associated diseases with coal workers pneumoconiosis

silicosis
scleroderma, RA nodules
caplan syndrome

17

What is caplan syndrome

RA with large cavitary pulmonary nodules associated with silicosis and coal workers pneumoconiosis

18

What will CXR look like in coal pneumoconiosis

resembles silicosis, small rounded opacities in the lung parenchyma
can prgress to PMF with nodules from 0.5-5cm

19

what will PFT show in coal pneumoconiosis

normal in early phase
often obstructive in later
someitmes restriction in fibrosis present
shown to lead to emphysema

20

Dx of coal pneumoconiosis

coal dust exposure, CXR

21

management of coal pneumoconiosis

avoid exposure and stop smoking

22

Asbestosis

chronic fibrotic interstitial lung disease secondary to prolonged inhalation of asbestos fibers
20 yr latency between disease and exposure is common

23

What industries are at risk for asbestosis

mining, milling and transportation of asbestos, building demolition, brake lining, shipbuilding, insulations, fireproofing

24

What is pathology of asbestosis

ferruginous bodies, asbestos bodies can be found in sputum or BAL fluid

25

Sx and signs asbestosis

dyspnea, dry cough, chest tightness/pain
inspiratory basal crackles and clubbing

26

what diseases are associated with asbestosis

mesothelioma
lung cancer
pleural effusion

27

CXR for asbestosis

pleural plaques, pleural effusion with latency 10-15 yrs
pleural thickening and rounded atelectasis with comet tail, lower lobe and subpleural diseases prominent

28

PFT for asbestosis

restrictive, may see obstructive

29

Dx of asbestosis

1 reliable Hx of exposure!!!
2 appropriate lag time between exposure and disease
3 lung fibrosis on CXR!!!
4 restrictive PFT
5 b/l inspiratory crackles
6 clubbing

30

management of asbestosis

no effective Tx, avoid exposure, stop smoking, lung transplant

31

What industries are at risk for beryllium disease

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

32

What is clniical presentation of acute toxic penumonitis(beryllium disease)

high exposure can lead to HS response that is now rare due to better recognition of beryllium assoc disease
Sx: cough and chest pain
Signs: blood tinged sputum and crackles

33

Clinical presentation of chronic beryllium disease

similar to sarcoidosis from asymptomatic to severe granulomatous restrictive lung disease
Sx: dyspnea, cough, chest pain, weight loss, fatigue and arthralgias
signs: crackles
osnet 20 yrs after exposure

34

what will CXR show in beryllium disease

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

35

PFT of beryllium disease

restrictive

36

Dx beryllium disease

documented exposure
evidence lung disease
+ BeLPT performed on blood or BAL fluid

37

What is BeLPT

beryllium lymphocyte proliferation test

38

Management of beryllium disease

avoid further exposure, stop smoking, steroids