Occ Med Flashcards
Asbestos related plural plaques are associated with which type of PFT pattern
Normal
Asbestos fibrotic disease is usually associated with what type of asbestos?
Amphibole
Asbestos related pleural effusions usually occur within how many years?
10
Metal fume fever is caused by ___ and the time course is ___?
Welding fumes
Tachyphalaxis within ~48 hours
What joint is most commonly affected with decompression sickness?
Shoulder
MSK pain most common symptom of compression sickness
Chrome salts are skin/respiratory sensitizer/irritant? (Choose all that apply)
Skin sensitizer and irritant
A rare form of occupational asthma caused by inhaling hemp, flax, or cotton particles
Byssinosis
In the United States, byssinosis occurs almost exclusively in people who work with unprocessed cotton.
What is Caplan syndrome?
Aka Rheumatoid pneumoconiosis
Pulmonary rheumatoid nodules in pts w/ rheumatoid arthritis who’ve breathed in coal, asbestos or silica
Osseous complication of decompression illness
Dysbaric osteonecrosis
Risk factors (3) for dysbaric osteonecrosis
Obesity, alcohol, steroid use
Wood dust is a type I (known) carcinogen of … (3)
Nasopharynx, nasal cavity and paranasal sinuses
What is the causative agent of silo filler’s dz?
Gaseous oxides of nitrogen from organic material
Arsenic is a type I (known) carcinogen of … (3)
Lung, skin and bladder cancer
Pain on thumb side of wrist from repetitive motion
De Quervains tenosynovitis
Also called: radial styloid tenosynovitis
Thickening of the palmar fascia most commonly affecting the 4th and 5th digits
Dupuytren’s contracture
____ syndrome of hand caused by trauma to ____ artery.
Hypothenar hammer syndrome
Ulnar artery
Specific gravity of toxic heavy metals
5 g/cm3 or heavier
Carbon monoxide poisoning causes the ___ curve to shift to the ___
Oxyhemoglobin curve
Left shift
Allergic contact urticaria is diagnosed with…
Skin prick test
Aluminum is a known carcinogen for (2) …
Bladder and lung cancer
High blood levels of aluminum are associated with…
Poor cognitive function
Systemic sclerosis is associated with what environmental exposures (2)
Silica
Organic solvents
Types of UV spectrum radiation from welding
All… UVA, UVB and UVC
___ skin discoloration from exposure to silver is called ___
Blue-grey
Argyria
Frequency range of human hearing
20 Hz to 200 kHz
Sign/symptoms associated w following Lead blood Levels
1) 30 mcg/dL
2) 50 mcg/dL
3) 100 mcg/dL
1) HAs & poor concentration
2) anemia and abd pain
3) encephalopathy
Treatment of de Quervain’s tenosynovitis
Thumb spica splint
Test for de Quervain’s tenosynovitis
Finklestein’s test
Ulnar deviation w thumb flexed
Sudden death from overwork
Karoshi
First line treatment of Achilles tendinopathy
PT: eccentric exercises
Physiology of noise induced hearing loss
Sensorineural HL due to loss of cilia and hair cells in cochlear
Nighttime sign of carpal tunnel syndrome
Flick sign
Symptomatic relief when waking at night and shaking out their hand.
93% sensitive &
96% specific for CTS.
treatment for methemoglobinemia
methylene blue (reduces methemoglobin hemoglobin)
in cases of ___ d/t chlorate exposure do not treat with methylene blue d/t risk of more toxic __ production
methemoglobinemia
hypochlorite
medications that cause methemoglobinemia (3)
dapsone (and other ABX)
benzocaine (& other -caines)
nitrites
Where does cyanide bind (2)
To Fe3+ in
1) methemoglobin
2) cytochrome C reductace in e- transport chain (irreversible)
(Prevents reduction back to Fe2+)
Most common cause of cyanide poisoning in US
Fires/fire fighting
Cyanide is removed from methemoglobin by the enzyme ___
and ___
is excreted in the ___
Liver rhodanase
Thiocyanate
Urine
(Na thiosulfate is consumed)
In cyanide poisoning
is PaO2 low/ normal / high?
is PvO2 low/ normal / high?
PaO2 is normal.
PvO2 is high.
They are ~ equal because O2 does offload to the tissue.
Normally O2 would diffuse to cytochrome oxidase in mitochondria, but cyanide fixes Fe3+ oxidase in the oxidized form.
2 foods that contain cyanide
Almonds (cyanide poisoning associated w “bitter almond” breath)
Apricots
Cherry red skin is associated with what type of poisoning
Carbine monoxide poisoning (rarely 2-3%)
{Another source aside Cyanide 2/2
Tissue unable to offload O2 so there is a high venous concentration of O2 - high PvO2 }
Cyanide poisoning antidote (3)
Na thiosulfate
Na nitrite
Hydroxycobalamine (vit B12)
Cyanide poisoning antidote that directly binds cyanide
Hydroxycobalamine
Cyanocobalamine excreted in urine
This cyanide antidote induces methemoglobin formation
Na nitrite
Fe3+ in Methemoglobin has affinity for CN
This cyanide antidote is utilized by liver rhodinase to remove CN from cyanomethemoglobin
Na thiosulfate
Thiocyanate excreted in urine
Q fever bacteria
Coxiella Burnetti
Q fever treatment
Doxycycline
Carbon disulphide
Acute exposure -> ?
Chronic exposure -> ?
Neurotoxicity
CAD
Poisons that inhibit cytochrome C oxidase in e transport chain (complex IV)
Cyanide
Carbon monoxide
Hydrogen sulfide (H2S)
Lyme disease is caused by…
Borrelia burgdorferi
Lyme disease single dose ABX prophylaxis
200mg doxycycline
Group 1 (known) carcinogen for melanoma
Polychlorinated biphenyls
Most dangerous type of UV radiation
UVB
UVC does not reach surface of earth
Occupational voice loss risk factors (4)
low humidity
high background noise
increased vocal load
poor upper body posture
Toluene diisocyante is a skin/respiratory sensitizer/irritant? (Choose all that apply)
respiratory sensitizer
It causes occupational Asthma in ~1% of people when exposure > 5ppb
Size at which fibers are respirable
less than 3 microns
type of mercury poisoning associated with intestinal necrosis and bloody diarrhea
ingestion of inorganic mercury salts
mechanism of Pb poisoning
Replaces elements such a Ca in many biological pathways
treatment of Itai-itai disease
cadmium chelators