MKSAP 4: Occupational Lung Disease Flashcards
What are some key factors of history that would increase suspicion of occupational lung disease?
The patient raises concern.
Temporal relationship to clinical symptoms and work.
Coworkers affected
Known respiratory hazards
Failure to respond to initial therapy that then worsens at work
Onset of respiratory disorder without typical risk factors
Clustering of disease in one geographic area
What is the overriding principle in occupational lung disease?
Prevention and avoiding exposures
What is abestos and why despite its elimination from use in the United States will it continue to be a public health threat?
Silicate mineral fiber previously used as insulating material that is a major cause of lung disease. Long latency period between exposure and disease development (15-35 years)
What industries are most at risk for asbestos lung disease?
Construction, automotive servicing, shipbuilding and mining industries
What is the most common finding on imaging for abestosis?
Parietal plaques
What are pleural plaques?
Pleural plaques are the most common form of disease and characterized by smooth, white, raised, irregular lesions affecting parietal and visceral pleura. Pleural plaques are asymptomatic in the absence of parenchymal disease and are typically identified on routine CXR
What is pleural fibrosis
visceroparietal pleural reaction that may be either localized or diffuse, when it is diffuse is can lead to symptomatic restrictive disease.
Treatment options are limited
Can lead to rounded atelectasis - mass like lesion that includes bronchi and vessels. Can lead to respiratory impairment is become large enough
What is benign asbestos pleural effusion
Can occur early or late after asbestos exposure. Can be asymptomatic or associated with chest pain. Pleural fluid will be exudative and often hemorrhagic. Eosinophils present in 1/3 of patients.
Describe silicosis and its clinical presentation and course
Silicosis is a spectrum of fibrotic lung diseases related to inhalation of silica dust. Small rounded nodules that are upper lobe predominant. Can be accelerated (3-10 years) or latent (>10 years)
What industries are at risk for silicosis
Any jobs that disturb the earth’s crust: processing silica rock or dust
patients with silicosis are at increased risk for what pulmonary infection?
TB
what are treatment options
Not many once disease progresses to fibrosis.
Smoking cessation, inhaled bronchodiators, antibiotics for infection, supplemental oxygen for hypoxemia. Lung transplant referral
