DSA Environmental Lung Injury

Question 1

PFT of pneumoconioses would show which pattern?

Answer 1

restrictive

Question 2

how many years of exposure before pneumoconioses form?

Answer 2

about 20 years

Question 3

4 pathogens that cause pneumoconioses

Answer 3

1. berrilym
2. coal
3. asbestos
4. silica

Question 4

asbestosis may cause which condition?

Answer 4

mesothelioma

10% develop this

Question 5

radiographic findings of asbestosis

Answer 5

pleural changes in periphery

Question 6

smoking + asbestosis exposure increases risk by

Answer 6

75 x

Question 6

laboratory finding for asbestosis

Answer 6

ferruginous bodies

(via lung biopsy)

Question 7

tx for asbestosis

Answer 7

supportive: vax
transplant

Question 8

most common pneumoconiosis

Answer 8

silicosis

Question 9

MC infections associated w/silicosis

Answer 9

mycobacterium

Question 10

test yearlyWhy are patiens with silicosis more prone to mycobacterial infection?

Answer 10

silica is cytotoxic to alveolar MF

test yearly

Question 11

Radiographic findings: silicosis

Answer 11

“egg-shell calcifications”

Question 12

How is berylliosis diagnosed?

Answer 12

blood berylium lymphocyte proliferation test (BeLPT)

Question 13

CXR findings: berylliosis (2)

Answer 13

1. diffuse intersttitial infiltrates
2. “light bulb”-appearing granulomas

Question 14

Answer 14

coal miners lung
“black lung”

nodular opacities

Question 15

difference between dry and wet drowning

Answer 15

• dry: small volume, laryngeal spasms –> high lung pressure & edema
• wet: large volume aspiration

Question 16

s/sx drowning (4)

Answer 16

1. hypoxemia, acidosis
2. cardiac arrhythmias
3. encephalopathy
4. electrolyte disturbances

Question 17

drowning tx (4)

Answer 17

1. establish airway
2. O2
3. b-agonists
4. Observe for 24 hours for ARDS

Question 18

How do you determine prognosis of drowning?

Answer 18

neurologic status

comatose = bad prognosis

Question 19

children can survive drowning, even after what legnth of submersion?

(hypothermic)

Answer 19

60 min

Question 20

MC altitude injury

Answer 20

acute mtn sickness

Question 21

sx of acute mtn sickness (4)

Answer 21

1. HA
2. malaise
3. anorexia
4. disturbed sleep

(>50% will develop over 14k feet)

Question 22

HACE sx

high altitude cerebral edema

Answer 22

1. severe HA
2. memory loss
3. hallucination
4. confusion
5. ataxia

most severe of altitude injury

Question 23

HAPE

high altitude pulmonary edema (non-cardiac)

Answer 23

1. cough
2. frothy sputum

Question 24

Altitude injury tx (5)

Answer 24

1. bring them down the mtn!! 1. O2 1. acetazolamide 1. salometerol 1. slow ascent (no more than 1,000/day)

Question 25

What happens when a person is exposed to carbon monoxide?

Answer 25

CO displaces O2 w/higher affinity for Hb | (200 times greater)

Question 26

CO sx (5)

Answer 26

1. **headache** 1. **Nausea** 1. dizzy 1. blurry vision 2. cherry red lips & nail beds

Question 27

Smoke inhalation injuries (2)

Answer 27

1. laryngeal edema --> obstruction 1. anoxia | usually upper airways only

Question 28

Fatal complications of smoke inhalation injury (3)?

Answer 28

1. pneumonia 1. ARDS 1. multiple organ failure

Question 29

CXR findings for smoke inhalation injury

Answer 29

diffuse, patchy infiltrates

Question 30

How long is a smoke inhalation patient observed?

Answer 30

48 hours | watch for singeing of nasal hairs

Question 31

smoke inhalation injury tx

Answer 31

close observation 100% oxygen