B23- Occupational Lung Diseases

Question 1

What substance in buttery popcorn caused 2-3% of workers to get obliterative broncholitis

Answer 1

Diacetyl ketone

Question 2

Nake 6 occupation lung diseases

Answer 2

Asthma
Infection
Acute lung injury 
Interstitial lung disease
Copd 
Lung cancer (asbestos)

Question 3

How many deaths in europe per year due to fumes or dust

Answer 3

39000

Question 4

Why is it hard to diagnose

Answer 4

Because has a long latency period. Develops overtime

Question 5

What is the most common old

Answer 5

Asthma

Question 6

What % of all asthma cases

Answer 6

15

Question 7

Give examples

Answer 7

Proteins from animals, favrics, detergents, metalic agents or chemicals can cause an asthmatic response

Question 8

What is exacerbation at work of already caused asthma called

Answer 8

Work aggrevated asthma

Question 9

Give 2 examples where occupation cuases risk of infrction

Answer 9

TB in healthworkers

Legionnaires disease in air ventilated areas eg schools, leisure centres

Question 10

What are acute inhalation injuries

Answer 10

Where 1 major expsure eg to dist, gas fumes, fire cwn trigger lung injuries eg ards onset

Question 11

Give an example

Answer 11

Bhopal disaster, isocyanate gas fumes

Question 12

What % had resitrcitive diseases

Answer 12

13.3%

Question 13

What is the proper name for dust diseases

Answer 13

Pneumoconiosis

Question 14

Give 4 examples

Answer 14

Coal workers lung
Silicosis
Asbestosis
Asbestos cancer

Question 15

Give some mineral dust examples vs organic

Answer 15

Coal, silica, asbestos

Vs

Cotton, hay

Question 16

What is an inert response to dust

Answer 16

Where it needs to be overtime collection to have effect eg cml

Question 17

What is a fibrous reactikn

Answer 17

Reaxtikn to fibrous dust eg asbestosis

Question 18

Why are fibrous reactions ahrd to get rid of by immunity

Answer 18

Macrophages cant digest them

Question 19

Five an example of an allergic response to dust

Answer 19

Extrinsic allergic alveolitis

Question 20

What is an example of a neoplastic effect (abnormal change eg cancer)

Answer 20

Mesothelioma (by asbestos)

Question 21

Particles of what size are not likely to get to lower airways

Answer 21

10 um

Question 22

What suze are small enough to diffuse wirh has across to blood

Answer 22

0.5um

Question 23

Which particles are most dnagetous and why eg asbestos

Answer 23

1-5um because they deposit in lungs overtime and damage

Question 24

What does parhogensis of pneumocioniosis via 1-5um dust depend on

Answer 24

Conc of dust 
Duration of exposure
Type of dust (asbestos is worse) 
Genetic susceptibility of woker 
Other inhaled irritants

Question 25

Which kind of dust needs to be dposited a llng time for pneumoconiosis occur

Answer 25

Inert eg coal

Question 26

Where sre particles going after being englufed by mscrophegaes

Answer 26

Either out by mucociliaty or to lymph/blood

Question 27

What do most reactive patticles allow

Answer 27

Killing of macrophage and subsequent release of them eg in the blood

Question 28

How does rhis cause emphysema

Answer 28

By sm ateophy and sm breakdown

Question 29

Sre these pneumoconiosis effects localised

Answer 29

Yes

Question 30

When dust builds up up to 10um forming nodules what can this cause

Answer 30

Chronic fibrosis (because of damage) and honeycombing, sitffness, hypoxia, deposition in capillaries

Question 31

What is the first stage of pneumocionsis called (not too bad)

Answer 31

Pulmonary anthracosis

Question 32

What is pulmonary anthrocosis

Answer 32

Carbon rxposure and deposition eg in smokers, urban dwellers, cw.

Question 33

What happens to the carbon/coal build ip

Answer 33

Ingested by macrophages in alveoli and deposits in connrcgive tissue or lymphatics

Question 34

Its harmeless at first but what can happen

Answer 34

Emphysema eventually at connectivr tissue/smooth muscle

Question 35

What is simple cwp and what can it cause

Answer 35

Coal laege nodules forming in lungs ans overtime causes dilation of adjacent alvoeli and centrilobulsr emphysema (Coal also causes things like fibrosis)

Question 36

What is complicated cwp aslincalled

Answer 36

Progressive massive fibrosis

Question 37

What % of cwp ends up at pmf

Answer 37

10

Question 38

What is rhe pathogenssis of this

Answer 38

2-10cm balckened scars due to fibrosis effects of dust psrtickes building up overtime

Question 39

What is the centre of the blackened scars in pmf

Answer 39

Necrotic tissue/dead tissue

Question 40

Which dust causes silocosis

Answer 40

Crystalline silicon dioxide dust

Question 41

How mayy yesrs does it take gi develop

Answer 41

20-30 years

Question 42

How small ste they so depositied

Answer 42

1um

Question 43

Name some sources

Answer 43

Mining, quarrying , tunneling

Question 44

Is it inert

Answer 44

No. Has damaging effect such as pmf/silicosis

Question 45

What is silociss a type of

Answer 45

Pm fibrosis

Question 46

Silica is reactive enough to activate macrophages. What does this do

Answer 46

Allow macrophage release of ros and cytokines eg il1(recruits neutrohils)

Question 47

Which group in silica in macrophages xan intersct with macromolecules luke carbs,lipids and NA

Answer 47

Silanol Sioh group

Question 48

What does this do

Answer 48

Kill macrophages cussing more silica rleease and also dmaahe to epithelial/lung membrnaes

Question 49

What do these effects all have

Answer 49

Fibrogenesis

Question 50

A fibrotic nodule forms which is what

Answer 50

Finrotic matedial eg collagen and surrounding inflammatort cells (activated because silica is so reactive)

Question 51

Which article discusses silicosis more

Answer 51

Hamilton et al 2009

Question 52

Can silica produce ros itself or just induce macorphages to

Answer 52

Can produce it itself which is fibrogenic as it dsmshes epithelia

Question 53

Which inflammasome is activated by these radicals causing activation of cytokines like il1b = lmyphocyte involvemnet

Answer 53

Nalp3

Question 54

How else does silica allow t lymphocyte induction

Answer 54

Increase ag presentstikn by mscrophages and also induce migration of dc to alveoli for apc

Question 55

Where can asbestos be

Answer 55

Insulation, roofing material

Question 56

It causes diffuse ipf. Where does this start the spread

Answer 56

Respiratory bronchioles

Question 57

Where does fibrosis gradually extend to (kawabata 2019)

Answer 57

To pleura ie causing mesothelioma cancer in pleura

Question 58

Which cancer has a 5x risk due to asbestos

Answer 58

Bronchogenic carcinoma

Question 59

What other thing with asbestos causes bronchogenic c

Answer 59

Smoking together

Question 60

What x risk does asbestos have on mesothelioma

Answer 60

1000x (90% of causes are asbestos)

Question 61

Where is mesothelioma tumour

Answer 61

In pleura which causes subseqeuent restirction

Question 62

Which article discusses asbestos related diseases including asbestosis

Answer 62

Kamp 2009

Question 63

What was the synergistic effect of smoking and abestos on bc

Answer 63

Dna damage and impaired fibre clearance

Question 64

What do mac execesdivelt cause when exposed to asbestos

Answer 64

Oxidatice stress ie causing fibrosis

Question 65

How do lung epithelia take up asbestos causing damage

Answer 65

Avb5 integrin

Question 66

Which pathway due to excessive ros (caused dna damage)release in asbestosis caused aec apoltosis

Answer 66

P53 pathway