Sarcoidosis & Pneumoconiosis Flashcards Preview

Clin Med I - Pulmonary > Sarcoidosis & Pneumoconiosis > Flashcards

Flashcards in Sarcoidosis & Pneumoconiosis Deck (51):
1

Define sarcoidosis

- chronic, multisystem, inflammatory, granulomatous disorder

2

What is the etiology of sarcoidosis

- unknown

3

How does sarcoidosis manifest?

- noncaseating granulomas in lungs & intrathoracic LN

4

What presents with caseating granulomas?

- TB

5

Define pneumoconiosis

- occupational and environmental restrictive lung disease

6

What is the pathophysiology of sarcoidosis?

- T cells cause an excessive cellular immune reaction
- leads to central immune system activation
- excessive T cell collection leads to granuloma formation

7

What is the identifying hallmark of sarcoidosis?

- non-caseating granulomas

8

What are the MC organs affected by sarcoidosis?

1. lungs
2. skin
also LN & eyes

9

What pulmonary findings will present with sarcoidosis?

- usually normal
- crackles
- exertional O2 desat

10

What are the dermatological findings with sarcoidosis?

- erythema nodosum
- LE maculopapular rash
- lupus pernio (most specific)
- violacious rash on the cheeks or nose

11

What are the ocular findings of sarcoidosis?

- uveitis

12

How is sarcoidosis dx'd?

- CXR
- CT
- gallium scan
- bx
- PFTs

13

What is stage 0 sarcoidosis?

- normal CXR

14

What is stage I sarcoidosis?

- (B) hilar LAD

15

What is stage II sarcoidosis?

- (B) hilar LAD
- infiltrates

16

What is stage III sarcoidosis?

- infiltrates only

17

What is stage IV sarcoidosis?

- fibrosis

18

What is the MC abnormality on PFTs

- isolated decrease in DLCO

19

What else must be tested in sarcoidosis?

- CV, not diagnostic

20

What is the tx of sarcoidosis for pulmonary dz?

- prednisone
- steroids

21

What is the tx for extrapulmonary sarcoidosis dz?

- steroids

22

What is the tx for ocular sarcoidosis dx?

- steroids

23

When is a lung transplant part of the tx of sarcoid?

- advanced pulmonary fibrosis

24

Define asbestosis

- diffusing pulmonary interstitial fibrosis occurring in asbestos exposed workers/bystanders/community

25

Describe the pathology of asbestosis

- inhalation of asbestos fibers leads to inflam with scarring of alveolar-capillary membrane leading to pulm fibrosis & functional deterioration

26

What is asbestosis directly related to?

- intensity & duration of exposure

27

When does asbestosis manifest?

- 10-20y s/p exposure

28

What are the S&S of asbestosis?

- dyspnea on exertion
- chest pain
- productive cough
- concomitant bronchitis or respiratory infx
- rales

29

What is seen on CXR in asbestosis?

- pleural plaques
- pleural effusion
- irregular, linear opacities in lower lung

30

What is seen on PFT in asbestosis?

- normal FEV1/FVC ratio
- decreased FC, TLC, and DLCO

31

What is seen on bx of asbestosis?

- fibrosis
- fibers/asbestos bodies

32

What is the tx for asbestosis?

- smoking cessation
- tx early S&S PNA
- bronchodilator/steroids/O2
- lung transplant

33

What are potential complications of asbestosis?

- cor pulmonale
- malignancy
- PAH
- R sided heart failure

34

What is the primary prevention of asbestosis?

- follow OSHA guidelines

35

What is the secondary prevention of asbestosis?

- vaccinations

36

Define Coal Worker's Pneumoconiosis (CWP)

- chronic, usually occupational acquired, restrictive lung disease from respirable coal dust

37

What is the pathophysiology of CWP?

- dust laden macrophages accumulate in the alveoli and trigger immune response
- coal macules form discrete areas of fibrosis

38

What is seen on PE in CWP?

- asx
- chronic bronchitis/COPD sx
- cough, dyspnea, lung function impairment

39

What test should be done for CWP?

- CXR
- CBC
- PFTs

40

What is the tx for CWP?

- symptomatic
- O2 for hypoxemia
- serial CXR monitoring
- smoking cessation
- immunizations
- transfer jobs

41

What are potential complications from CWP?

- progressive massive fibrosis
- Caplan Syndrome
- TB
- CA

42

Define silicosis

- fibronodular lung dz caused by inhalation of dust containing crystalline dust

43

How does silicosis present?

- dyspnea
- cough
- weakness

44

What is the testing for silicosis?

- CXR
- CT
- PFTs
- PPD (mantoux)

45

What is seen on CXR in silicosis?

- (B) alveolar filling
- ground glass
- small nodules
- eggshell calcifications

46

What is the tx for silicosis?

- prevent further exposure
- quit smoking
- immunize
- steroids
- lung transplant
- tx active TB & other complications

47

What is the pathophysiology of chronic beryllium dz?

- Tc --> proinflam cytokines --> non-caseating granulomatous inflam

48

What are the S&S of chronic beryllium dz?

- dyspnea
- cough
- chest pain
- arthralgia
- fatigue
- wt loss
- inspiratory crackles
- LAD
- rash
- hepatosplenomegaly

49

How is chronic beryllium dz diagnosed?

- blood/bronchoalveolar lavage (BAL)
- beryllium lymphocyte proliferation test (BeLPT)
- CT
-spirometry

50

What will be seen on CT in chronic beryllium dz?

- ground glass opacification

51

What is the tx for chronic beryllium dz?

- refer
- symptomatic tx
- steroids, if they fail methotrexate
- O2