Interstitial Lung Disease DSA III

Question 1

coal workers pneumoconiosis

Answer 1

coal dust deposit in lung

risk increase with intensity of exposure and carbon content

anthracite is most toxic

Question 2

risk for coal workers pneumoconiosis

Answer 2

underground miners at more risk than surface miners

Question 3

path of coal workers pneumoconiosis

Answer 3

coal macule consisting of macrophages laden with coal dust within walls of resp bronchioles and adjacent alveoli

coal nodules

progressive massive fibrosis

Question 4

clinical for coal miners pneumoconiosis

Answer 4

no sx or signs

possible bronchitis

may lead to progressive massive fibrosis

Question 5

caplan syndrome

Answer 5

rheumatoid arthritis and large cavitary pulmonary nodules associated with silicosis and coal workers pneumoconiosis

Question 6

CXR for coal workers pneumoconiosis

Answer 6

small rounded opacitines in lung parenchyma

can progress to progressive massive fibrosis - nodules 0.5 - 5cm

Question 7

PFT for coal workers pneumoconiosis

Answer 7

normal early phase
obstructive later on
may show restriction

coal dust - shown to cause emphysema

Question 8

Dx of coal workers pneumoconiosis

Answer 8

coal dust exposure

CXR

Question 9

Tx coal workers pneumoconiosis

Answer 9

avoid exposure

stop smoking

Question 10

asbestosis

Answer 10

chronic fibrotic interstitial lung disease secondary to inhalation of asbestos fibers

20 year latency between disease and exposure is common

Question 11

risk for asbestosis

Answer 11

mining
milling
transport asbestos
demolition
brake lining
ship builders
insulation
fireproofing

Question 12

ferruginous bodies

Answer 12

asbestos bodies
-found in asbestosis

sputum or BAL fluid

Question 13

disease associated with asbestosis

Answer 13

mesothelioma
lung ca
pleural effusion

Question 14

CXR for asbestosis

Answer 14

pleural plaques and effusion
pleural thickening
rounded atelectasis with comet tail**
lower lobe and subpleural prominent

Question 15

PFT for asbestosis

Answer 15

restrictive

some obstructive

Question 16

Dx of asbestosis

Answer 16

Hx of exposure
appropriate time after exposure
lung fibrosis on CXR
bilatral crackles
clubbing fingers or toes
restrictive PFT

Question 17

Tx of asbestosis

Answer 17

no Tx
avoid exposure
stop smoking

consider lung transplant

Question 18

risk for beryllium disease

Answer 18

aerospace
electronics
ceramics
metal
nuclear
telecommunications
tool and die
welding

Question 19

acute toxic pneumonitis

Answer 19

high exposure to beryllium

-hypersensitivity response that is now rare due to better recognition of beryllium associate disease

Question 20

chronic beryllium disease

Answer 20

asymptomatic to severe granulomatous restrictive lung disease

dyspnea, cough, chest pain, weight loss, fatigue, arthralgias, crackles

20 or more years after exposure

Question 21

all sarcoid patients

Answer 21

consider beryllium exposure

Question 22

CXR for beryllium disease

Answer 22

enlarge hilar or mediastinal nodes

or multi lung nodules

or both

later stages - patchy fibrosis, hyperinflation, honeycombing

Question 23

Dx of beryllium disease

Answer 23

exposure to beryllum
lung disease

positive BeLPT (beryllium lymphocyte proliferation test performed on blood or BAL fluid)

Question 24

Tx of beryllium disease

Answer 24

avoid exposure
stop smoking
steroids