Environmental Lung Diseases

Question 1

Psittacosis is acquired from contact with what?

Answer 1

Birds (parrots, parakeets, pigeons, chickens, etc)

Question 2

A patient in his 50s presents to clinic with progressive dyspnea, inspiratory crackles. On CXR you see opacities of all shapes and sizes as well as honeycomb changes. He tells you he works in construction. What do you think he’s been exposed to?

Answer 2

Asbestos

Question 3

You see “eggshell calcification” of the perihilar lymph nodes and small round opacity throughout the lung on CXR. What has this patient most likely inhaled?

Answer 3

Silica.

Question 4

The incidence of what disease is increased in patients with silicosis?

Answer 4

TB

Question 5

Patient presents with rapid onset of fever, chills, myalgias, dry cough and temperature-pulse dissociation but no pulmonary findings. CXR indistinguishable. Whats the next step?

Answer 5

Serum antibodies will test positive for psittacosis

Question 6

Whats the DOC for Psittacosis?

Answer 6

tetracycline

Question 7

XR findings of complicated silicosis can resemble those in the upper lobes of what?

Answer 7

Complicated Coal worker’s pneumoconiosis

Question 8

What is the condition that can develop in patients with rheumatoid arthritis and coal workers?

Answer 8

Caplan syndrome - see necrobiotic rheumatoid nodules in the periphery of the lung

Question 9

True/False. Prompt removal of the offending agent can reverse the symptoms associated with Hypersensitivity pneumonitis?

Answer 9

True! Continued exposure may lead to progressive disease

Question 10

Soil infected with bird or bat droppings in the ohio and mississippi river valleys can cause…

Answer 10

Histoplasmosis!

Question 11

Widespread histoplasmosis is especially common in which population?

Answer 11

AIDs or other immunocompromised states

Question 12

What is the treatment of choice for Histoplasmosis?

Answer 12

Itraconazole

Question 13

Cigarette smoking in asbestos workers increases the incidence of:

Answer 13

lung carcinoma

Question 14

What do PFTs show on a patients with asbestosis?

Answer 14

RESTRICTIVE dysfunction and reduced diffusing capacity

Question 15

What is the specific treatment for asbestosis?

Answer 15

There is none!

Question 16

See a furruginous body in tissue suggests what?

Answer 16

Asbestosis

Question 17

What is required for management of silicosis patients?

Answer 17

All should have a TB skin test and current CXR

Question 18

T/F. Cigarette smoking increases the prevalence of Coal Worker’s Pneumoconiosis.

Answer 18

False! But may have a detrimental effect on ventilatory function

Question 19

How do you diagnose Hypersensitivity pneumonitis?

Answer 19

Histopathology of interstitial infiltrate of lymphocytes and plasma cells, with noncaseating granulomas in the interstitium and air spaces.

Question 20

Which of these are typically diagnosed as atypical pneumonia?

Answer 20

Histoplasmosis

Question 21

Which demographics are most likely to get these?

Answer 21

Hispanics are more likely to be employed in high risk occupations with respiratory hazards