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Z Year3 Resp Conditions > Occupational Lung Disease > Flashcards

Occupational Lung Disease Flashcards

1
Q

What can occupational lung disease be classed as?

A

Pneumoconiosis

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2
Q

What are different types of occupational lung disease?

A
  1. Coal worker pneumoconiosis (CWP)
  2. Progressive massive fibrosis
  3. Caplan’s sydnrome
  4. Silicosis
  5. Chronic beryllium disease
  6. Asbestosis
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3
Q

What is CWP?

A
  1. Common dust disease in countries underground coal mines

2. Inhalation of coal dust particles over 15-20yrs

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4
Q

What is the patho of CWP?

A

ingested by macrophages which die, releasing their enzymes causes fibrosis

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5
Q

What are symptoms of CWP?

A

asymptomatic but coexisting chronic bronchitis common

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6
Q

What would CXR show in CWP?

A

many round opacities (1-10mm) esp in upper zone

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7
Q

What is progressive massive fibrosis caused by?

A

progression of CWP

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8
Q

What are symptoms of progressive massive fibrosis?

A
  1. progressive dyspnoea
  2. fibrosis
  3. cor pulmonale
  4. Extertional dypnoea + cough +/- black sputum
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9
Q

What would CXR show in progressive massive fibrosis?

A
  1. bilateral upper zone fibrotic masses (1-10cm) develop from periphery towards hilum
  2. large round fibrotic masses in upper lobes
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10
Q

What is Caplan’s syndrome?

A

association between RA, pneumoconiosis and pulmonary rheumatoid nodules

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11
Q

What is silicosis caused by?

A

inhalation of silica particles which are fibrogenic

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12
Q

What sort of work may get silicosis?

A

metal mining, stone quarrying, sand blasting and pottery/ceramic manufacture

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13
Q

What would the symptoms of silicosis be?

A
  1. progressive dyspnoea

2. increase incidence of TB

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14
Q

What would CXR show in silicosis?

A
  1. diffuse military or nodular pattern in upper and middle zones
  2. egg shell calcification of hilar nodes
  3. Upper lobe fibrotic masses often with hilar “egg shell calcifications”
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15
Q

What would spirometry show in silicosis?

A

restrictive ventilatory defect

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16
Q

What investigations are done for occupational lung disease?

A
  1. CXR
  2. Spirometry
  3. Beryllium lymphocyte proliferation test
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17
Q

What are some DDx for occupational lung disease?

A
  1. Asbestosis
  2. IPF
  3. Sarcoidosis
  4. Rheumatoid arthritis
18
Q

What is the treatment for acute secondary alveolar proteinosis (acute silicosis)?

A

lung lavage

19
Q

What is the treatment for acute berylliosis?

A

corticosteroid therapy

20
Q

What is the 1st line treatment for ongoing silicosis, CWP or chronic berylliosis?

A

1st line: smoking cessation + removal or occupation exposure

21
Q

What would you add to the treatment with chronic berylliosis?

A

corticosteroid therapy

22
Q

What would you add to the treatment with exertional dyspnoea?

A

pulmonary rehab

23
Q

What would you add to the treatment with hypoxia?

A

supplementary oxygen

24
Q

What would you add to the treatment with COPD?

A

bronchodilator therapy

25
Q

What would you add to the treatment for end stage rep failure?

A

referral for lung transplant

26
Q

What are possible complications for occupational lung disease?

A
  1. COPD
  2. Chronic renal failure
  3. Non small-cell lung cancer
  4. Small cell lung cancer
  5. Cor pulmonale
  6. Acute bronchitis or pneumonia
  7. Rheumatoid arthritis
27
Q

What should all occupational lung disease get?

A

compensation!!

28
Q

How do you treat CWP?

A

treat chronic bronchitis, claim compensation

29
Q

What is simple pneumoconiosis?

A
  1. Exertional dyspnoea and cough

2. Category 1-3 based on CXR

30
Q

What is the aietology of hypersensitivity pneumonitis aka extrinsic allergic alveolitis?

A

inhaled microscopic allergens that deposit in small airways and alveoli, leads to allergic response in small airways and alveoli

31
Q

What are different types of hypersensitivity pneumonitis?

A
  • Farmer’s lung: mouldy hay or vegetables
  • Bird fancier’s lung: pigeons esp poo
  • Malt worker’s lung
  • cheese washes
32
Q

What is the classic history of of hypersensitivity pneumonitis?

A
  1. Exposure to allergen
  2. Dyspnoea
  3. Cough +/- sputum
  4. Malaise
33
Q

What is acute hypersensitivity pneumonitis?

A
  • 4-6 hr after exposure
  • fever/flu like symptoms
  • resolves within 48hr
34
Q

What is subacute hypersensitivity pneumonitis?

A

-symptoms after lower dose exposure with slow recovery over weeks/months

35
Q

What is chronic hypersensitivity pneumonitis?

A

-insidious onset + weight loss +/- clubbing and is progressive with fibrosis which can be fatal

36
Q

What would examination sign show on hypersensitivity pneumonitis?

A
  1. Nothing distinct
  2. bilateral diffuse or basal end inspiratory creps
  3. maybe inspiratory wheeze
  4. clubbing
37
Q

What investigations are done for hypersensitivity pneumonitis?

A
  1. Nothing pathopneumonia
  2. FBC/ESR/CRO for infection/inflammation
  3. CXR
  4. HRCT
  5. Antibody testing
  6. Lung function non specific restriction with low DLCO
38
Q

What would CXR show for hypersensitivity pneumonitis?

A

patchy nodular infiltrates in acute or sub acute and fibrosis in chronic

39
Q

What would HRCT show in hypersensitivity pneumonitis?

A

ground glass

40
Q

What is differential for hypersensitivity pneumonitis?

A

Asthma triggered by antigen

41
Q

What is management for hypersensitivity pneumonitis?

A
  1. Avoid allergen
  2. Steroids if symptoms persist after allergen removal
  3. Farmer lung eligible to comp

Z Year3 Resp Conditions (20 decks)

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