occupational lung disease Flashcards
what is pneumoconiosis ?
an interstitial lung disease associated with inhalation of certain fibres initiating an inflammatory process and eventually leads to fibrosis of the lungs
what is the primary prevention of occupational lung diseases ?
reduce exposure
what is the primary exposure inn asbestos ?
during mining and milling
what are the secondary exposure causes of asbestos ?
manufacturing using asbestos as with pipe workers
paint and cloth production
brake lining
ship construction
what are the asbestos related lung diseases ?
pleural disease ( moat common )
asbestosis
bronchogenic carcinoma
what are the associated pleural diseases ?
pleural plaques
pleural effusion
diffuse pleural thickening
rounded atelectasis
mesothelioma
what do pleural plaques look like on chest x ray ?
localized thickening and calcifications along the level of the diaphragm
what is diffuse pleural thickening commonly confused with ?
mesothelioma
what is the differential diagnosis of rounded atelectasis ?
lung cancer (pseudocancer)
where is the affection in asbestosis ?
in the lower lung fields
what is heard on auscultation of asbestosis ?
bilateral, inspiratory rales
how does asbestosis look like on chest x ray ?
bilateral diffuse reticulonodular opacities and honeycombing
what is evident in the lung biopsy in asbestosis ?
barbell shaped fiber ( golden brown fusiform rods)
what is silicosis caused by ?
inhalation of silica dust
what occupations are associated with silicosis ?
mining
ceramic work
sandblasting
glass and pottery
what does the pathology look like in silicosis ?
silicotic nodules
what does acute silicosis look like on a chest x ray ?
diffuse alveolar filling pattern with lower lung zone predominance
what does chronic scoliosis look like on chest X ray ?
nodules that are found in the upper lung lobe
nodules eventually turn into Progressive massive fibrosis
eggshell calcification of lymph nodes
what is the most characteristic findings on an X ray of chronic silicosis ?
eggshell calcification of lymph nodes
what is silicosis most commonly complicated by ?
tuberculosis , must have a tuberculin skin test done
what is the cause of coal worker pneumoconiosis ?
parenchymal lung disease due to inhalation and deposition of coal mine and dust
what is NOT a common characteristic found in coal worker pneumoconiosis ?
crackles and clubbing
what are the x ray findings in simple CWP ?
small rounded opacities in the upper zone
what are the primary lesions of CWP ?
coal macules
what can a coal macule eventually develop into ?
coal nodule
what is caplan syndrome ?
rheumatoid pneumoconiosis
association of rheumatoid arthritis and workers who have breathed in silica or coal
how to treat caplan syndrome ?
deal with RF alone and PMF alone
what kind of pattern is observed in ILD ?
restrictive
what kind of pattern is seen in COPD ?
obstructive pattern
how can we tell the difference between restrictive and obstructive patterns ?
restrictive pattern the FEv1/FVC ratio remains unchanged
so we need to look at each element alone
whilst
obstructive patterns the ratio is decreased
in what type of diseases do we see a decrease in DLCO ?
in obstructive lung diseases such as COPD
when could there be an increase in DLCO ?
alveolar haemorrhage
polycythemia
when is clubbing seen ?
toxic
hypoxic
malignant
what is thee sign seen on HRCT that denotes rounded atelectasis ?
comet tail sign
what do the pulmonary function tests look like in asbestosis ?
restrictive impairment
reduction in lung volumes
decreased DLCO
what stain is used in the alveolar sputum sample in sarcoidosis ?
Prussian blue
patients who have coal worker pneumoconiosis are at a greater risk of developing ?
COPD
what is the onset of asbestosis after exposure to asbestos ?
prolonged latency period
