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M103 T4 > M103 T4 L17 > Flashcards

M103 T4 L17 Flashcards

1
Q

What are the different types of occupational lung diseases?

A

COPD
Malignant diseases
Occupational asthma
Pneumoconioses (mineral dust)

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2
Q

What are examples of malignant occupational lung diseases?

A 
Lung cancer (asbestos and non asbestos related)
Mesothelioma
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3
Q

What are examples of pneumoconioses? (CAS)

A

Coal Workers’ Lung
Asbestosis
Silicosis

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4
Q

What are pneumoconioses caused by?

A

the inhalation of certain dusts

the lung tissue’s reaction to the dust

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5
Q

Which job occupations are linked to silicosis?

A 
Slate workers (Wales)
Potters (Stoke-on-Trent)
Knife grinders (Sheffield)
Hard rock miners (Canada etc)
Sand-blasting
Foundry workers
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6
Q

What is silicosis a risk factor for?

A

lung cancer

TB

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7
Q

What is the main aim for treatment of pneumoconioses?

A

to prevent further exposure

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8
Q

Which symptoms of pneumoconioses have to be managed? (BCCD)

A

breathlessness, cough, cor pulmonale & dyspnoea

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9
Q

Which areas was asbestos historically mined in?

A

Canada
Australia
South Africa

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10
Q

How did asbestos get to the UK?

A

it was imported via docks (esp Southampton)

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11
Q

When was asbestos widely used?

A

in the 1930s-70s

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12
Q

What was asbestos used in?

A 
building (roofs, insulation, plumbing)
power stations
ship-building (engine rooms, bulkheads)
railways
cars (brake pads)
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13
Q

Other than from working in astestos-containing environments, how else could people get related illnesses?

A

family members at home who washed contaminated clothes

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14
Q

When did Europe bring in a ban on all forms of asbestos?

A

2005

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15
Q

Is asbestos still used?

A

yes, there are other countries outside of teh EU that are mining and exporting asbestos

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16
Q

Which benign conditions can asbestos cause?

A

pleural plaques / thickening
benign pleural effusion
asbestosis

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17
Q

What is the effect of pleural thickening?

A

restriction on lung function

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18
Q

What do pleural plaques indicate?

A

they are a marker of exposure

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19
Q

What pattern is seen on the lung function of a patient with penumoconioses?

A

a restrictive pattern of abnormality

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20
Q

How would FVC and gas transfer of a patient with pneumoconioses be affected?

A

FVC - reduced

gas transfer - reduced

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21
Q

Which malignant diseases can asbestos cause?

A

lung cancer

mesothelioma

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22
Q

What features of a patient history can indicate a malignant disease caused by asbestos?

A

Pleural plaques on previous CXRs
persistent unexplained chest pain
Weight loss
Breathless / unilateral pleural effusion

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23
Q

What are the two distinct scenarios of asthma related to work?

A

occupational

work-aggrevated

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24
Q

What is occupational asthma caused by?

A

by workplace exposure to asbestos

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25
Q

What is work-aggrevated asthma caused by?

A

by pre-existing cases that are exacerbated by asbestos in the workplace

26
Q

What are the other risk factors of occupational asthma? (SAR)

A

smoking
atopy
rhinitis

27
Q

What are two types of features in substances might lead to allergic occupational asthma?

A

HMW (80-90% cases)

LMW

28
Q

Which HMW substances can be assessed for by skin prick / allergy testing? (FALE)

A

Flour (bakers)
Animals (farmers)
Latex
Enzymes (eg detergents)

29
Q

What is the relationship between LMW or HMW substances and IgE antibodies?

A

low - independent of IgE

high - IgE-dependent

30
Q

Which LMW substances can be assessed for by skin prick / allergy testing in limited circumstances?

A

Isocyanates (printing, plastics)
Metals (welders)
Dyes (hairdressers)

31
Q

What might be a consequence of irritant induced asthma?

A

the patient developing asthma

32
Q

What are the two types of irritant induced asthma?

A

acute

subacute

33
Q

What is an example of an acute irritant induced asthma?

A

Reactive Airways Dysfunction Syndrome

34
Q

What substances can cause Reactive Airways Dysfunction Syndrome?
Can Chlorine Arise From Teachers Failing

A 
Caustic vapours	
Chlorine 
Ammonia		
Fire/Smoke
Tear Gas	
Floor Sealants
35
Q

What factors does exposure to a certain toxin depend on?

A

the concentration of the toxin / pollutant
the duration and intensity of the exposure
the route by which the exposure occured (skin vs inhaled)
the mechanism and metabolism of the toxin
any co-morbidities of the patient

36
Q

Which factors determine a patient’s susceptibility to developing allergic occupational asthma?

A

Genetic factors
Co-morbidity / underlying diseases
Environmental factors

37
Q

Which Genetic factor might contribute to a patient developing allergic occupational asthma?

A

the protective effect of HbS against falciparum malaria

38
Q

What are examples of Environmental factors that might contribute to a patient developing allergic occupational asthma?

A

Heat waves
cold snaps
smogs

39
Q

Why might a co morbidity contribute to a patient developing allergic occupational asthma?

A

the co morbidity might augment the clinical impact of the toxic load

40
Q

What is the difference between primary and secondary pollutants?

A

1o - are from fossil fuel combustion

2o - are from reactions between pollutants in the atmosphere

41
Q

What are examples of primary pollutants?

A

Nitrogen oxide
Sulphur dioxide (diesel)
Carbon monoxide
Particulate matter

42
Q

What are the outdoor sources of NO?

A

vehicle exhausts

power stations

43
Q

What are the indoor sources of NO?

A

fuel burning cookers
unfueled heaters
cigarette smoke

44
Q

What conditions are NOs associated with?

A

COPD

asthma

45
Q

What are the health effects of ground level ozone?

A

decreases lung function
decreases pro-inflammatory effects
increases response to inhaled allergens
increases respiratory morbidity

46
Q

What structures in the airways are affected by particulate matter?

A

cilia
cell DNA
mucus
epithelium

47
Q

What is the effect of airway structural elements on the human body?

A

affects airway structural elements
promotes airway inflammation
promotes IgE production

48
Q

What are the two categories of exposure that can be reduced?

A

Occupational

Environmental

49
Q

What can be done to reduce Occupational exposure to pollutants?

A

the use of FFP3 masks

Ventilation / extraction of chemicals

50
Q

What can be done to reduce Environmental exposure to pollutants?

A

Air quality warnings
Remain indoors, close windows
Minimise duration/intensity of outdoor activities

51
Q

Why are airway provocation tests performed in the first place?

A

bc people with sensitive lungs will be affected by a much lower dose of this medication than people with healthy lungs

52
Q

What is the objective of airway provocation tests?

A

to carefully to make sure specific drugs for individual patients is safe

53
Q

How do airway provocation tests work?

A

by breathing in gradually increasing doses of a medication that can irritate the airways and cause them to get narrower

54
Q

g What structures are indicative of Progressive Massive Fibrosis on CXRs?

A

a fibrotic pneumoconiotic lesion with a diameter of x > 1cm

the formation of large mass-like conglomerates, predominantly in the upper pulmonary lobes

55
Q

g What are the consequences of Progressive Massive Fibrosis?

A

progressive scarring, causes stiff lungs

56
Q

g What is Progressive Massive Fibrosis primarily caused by ?

A

conioses, which results in the activation of alveolar macrophages, which phagocytose dust particles after their deposition

57
Q

What medication is used to manage a cough & breathlessness?

A

opiates

58
Q

What medication is used to manage r. HF?

A

diuretics

59
Q

What can specific IgE assays test for?

A

allergic reactions in most HMW allergens and some LMW agents

60
Q

What are the effects of particulate matter in the airways?

A

Mucous production
Oxidative stress to cell DNA
Induction of epithelial apoptosis

61
Q

What is the difference between FFP 1, FFP 2 or FFP 3 masks?

A

the higher the number, the better the protection against toxic substances

M103 T4 (19 decks)

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