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Year 2 Resp Exam 2 > Interstitial Lung diseases, Part II, D Kinder, DSA > Flashcards

Interstitial Lung diseases, Part II, D Kinder, DSA Flashcards

1
Q

Silicosis

A

fibrotic lung disease caused by inhalation of crystalline silica in form of quartz

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2
Q

What industries are at risk for silicosis

A

mining, tunneling, excavating, quarrying, stonework, foundries, sandblasting, ceramics

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3
Q

What are the categories of silicosis

A

chronic
accelerated
acute
progressive massive

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4
Q

what is hallmark pathology of chronic silicosis

A

silicotic nodule characterized by whorled hyalinized collagen fibers with more peripheral zone of dust laden macrophages
most common form of silicosis

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5
Q

describe acclereated silicosis

A

nodules develop after 3-10 yrs exposure

clinical course is progressive

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6
Q

describe acute silicosis

A

develops 6 mo-2 yrs post exposure
dyspnea, cough, weight loss and rapid progress to respiratory failure and death
alveolar filling process

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7
Q

What characterizes progressive massive fibrosis

A

lesions at least 1 cm in diameter and larger
lesions involve upper lobe
leads to resp failure, cor pulmonale, weight loss and death

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8
Q

what are associated diseases with silicosis

A

TB
COPD and chronic bronchitis
collagen vascular disease: RA and scleroderma
lung cancer

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9
Q

CXR silicosis

A

symmetric nodular pattern with upper lobes

hilar adenopathy with eggshell calcification

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10
Q

acute vs progressive massive silicosis on CXR

A

acute- air space and interstitial pattern

progressive- coalescence of nodules with larger mass lesions

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11
Q

PFT silicosis

A

normal ealry in chronic

later it is mixed pattern

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12
Q

Dx silicosis

A

based on Hx and characteristic X ray changes

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13
Q

management silicosis

A

irreversible
avoid further damage
TB testing
stop smoking

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14
Q

when do you consider lung transplants in silicosis

A

acute and accelerated

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15
Q

What causes coal workers pneumoconiosis CWP

A

deposits of coal dust in lung
increase with intensity of exposure and carbon content
anthracite is most toxic

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16
Q

patholgy CWP

A

coal macule with macrophages laden with coal dust in walls of respiratory bronchiles and adjacent alveoli
coal nodules
may have progressive massive fibrosis

17
Q

clinical presentation CWP

A

no Sx or signs
can have Sx bronchitis
may lead to progressive massive fibrosis

18
Q

assoc diseases with CWP

A

silicosis
scleroderma and RA
caplan

19
Q

Caplan syndrome

A

RA with large cavitary pulmonary nodules assoc with silicosis and CWP

20
Q

CXR of CWP

A

resembles silicosis
small rounded opacities in the lung parenchyma
can progress to progressie massive fibrosis with nodules 0.5 cm- 5 cm

21
Q

PFT CWP

A

normal in early
often obstructive can have restrictive if fibrosis present
shown to lead to emphysema

22
Q

Dx CWP

A

coal dust exposure

CXR

23
Q

mangement CWP

A

avoid exposure

stop smoking

24
Q

What is asbestosis

A

chronic fibrotic interstital lung disease secondary to prolonged inhalation of asbestos fibers
20 latency after exposure

25
Q

industries at risk for asbestosis

A

mining, milling, transportation asbestos, building demolition, brake lining, ship building, insulations, fireproofing

26
Q

What is unique pathologically to asbestosis

A

ferruginous bodies, asbestos bodies

sputum or BAL fluid

27
Q

Signs and Sx asbestosis

A

signs: inspiratory crackles, clubbing
Sx: dyspnea, dry cough, chest tightness/pain

28
Q

Assoc diseases of asbestosis

A

mesothelioma
lung cancer
pleural effusion

29
Q

CXR asbestosis

A 
pleural plaques
pleural effusion
pleural thickening
rounded atelectasis with "comet tail"
lower lobe and subpleural disease prominent
30
Q

PFT asbestosis

A

restrictive

may be obstructive

31
Q

Dx asbestosis

A 
Hx exposure!!!!!
appropriate lag time exposure and disease
lung fibrosis on CXR or CT!!!!!!
restrictive PFT
b/l inspiratory crackles
clubbing
32
Q

management asbestosis

A

no effective Tx
avoid exposure
stop smoking
lung transplantation

33
Q

what industries are at higher risk beryllium disease

A

aerospace, electronics, ceramics, metal, nuclear, telecommunications, tool and die, welding

34
Q

clinical presentation acute beryllium disease

A

acute pneumonitis: high exposure
cough, dyspnea, chest pain
blood tinged sputum and crackles

35
Q

Sx chronic beryllium disease

A

dyspnea, cough, chest pain, lb loss, fatigue, arthralgias
similar to sarcoidosis ranging from asymptomatic to severe granulomatous restrictive lung disease
20 yrs post exposure

36
Q

CXR beryllium disease

A 
enlarged hilar or mediastinal nodes
or
multiple lung nodules
or 
both
later: patchy fibrosis, hyperinflation and honeycombing
37
Q

Dx beryllium disease

A

documented exposure to beryllium
evidence lung disease
positive BeLPT performed on blood or BAL fluid

38
Q

management beryllium disease

A

avoid further exposure
stop smoking
steroids

Year 2 Resp Exam 2 (33 decks)

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