Sarcoidosis & Pneumoconiosis Flashcards
(51 cards)
1
Q
Define sarcoidosis
A
- chronic, multisystem, inflammatory, granulomatous disorder
2
Q
What is the etiology of sarcoidosis
A
- unknown
3
Q
How does sarcoidosis manifest?
A
- noncaseating granulomas in lungs & intrathoracic LN
4
Q
What presents with caseating granulomas?
A
- TB
5
Q
Define pneumoconiosis
A
- occupational and environmental restrictive lung disease
6
Q
What is the pathophysiology of sarcoidosis?
A
- T cells cause an excessive cellular immune reaction
- leads to central immune system activation
- excessive T cell collection leads to granuloma formation
7
Q
What is the identifying hallmark of sarcoidosis?
A
- non-caseating granulomas
8
Q
What are the MC organs affected by sarcoidosis?
A
- lungs
- skin
also LN & eyes
9
Q
What pulmonary findings will present with sarcoidosis?
A
- usually normal
- crackles
- exertional O2 desat
10
Q
What are the dermatological findings with sarcoidosis?
A
- erythema nodosum
- LE maculopapular rash
- lupus pernio (most specific)
- violacious rash on the cheeks or nose
11
Q
What are the ocular findings of sarcoidosis?
A
- uveitis
12
Q
How is sarcoidosis dx’d?
A
- CXR
- CT
- gallium scan
- bx
- PFTs
13
Q
What is stage 0 sarcoidosis?
A
- normal CXR
14
Q
What is stage I sarcoidosis?
A
- (B) hilar LAD
15
Q
What is stage II sarcoidosis?
A
- (B) hilar LAD
- infiltrates
16
Q
What is stage III sarcoidosis?
A
- infiltrates only
17
Q
What is stage IV sarcoidosis?
A
- fibrosis
18
Q
What is the MC abnormality on PFTs
A
- isolated decrease in DLCO
19
Q
What else must be tested in sarcoidosis?
A
- CV, not diagnostic
20
Q
What is the tx of sarcoidosis for pulmonary dz?
A
- prednisone
- steroids
21
Q
What is the tx for extrapulmonary sarcoidosis dz?
A
- steroids
22
Q
What is the tx for ocular sarcoidosis dx?
A
- steroids
23
Q
When is a lung transplant part of the tx of sarcoid?
A
- advanced pulmonary fibrosis
24
Q
Define asbestosis
A
- 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
