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occupational lung disease Flashcards

1
Q

What is occupational lung disease known as

A

Pneumoconiosis

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2
Q

What are the main pneumoconiosis

A

Asbestosis
Silicosis
Coal workers pneumoconiosis (CWP)

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3
Q

What does pneumoconiosis lead to

A

pulmonary fibrosis and scarring of the interstitium

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4
Q

What is another name of CWP

A

Black lung

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5
Q

What is the causative agent of CWP

A

carbon containing particulate from coal mining

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6
Q

What is the importance of the federal coal mine and health and safety act of 1969

A

Established safety standards/inspections of coal mines

Established funding for workers who develop CWP

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7
Q

How does CWP present

A

Primarily asymptomatic

*if symptoms develop, they’re non-specific

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8
Q

What is first line dx test for CWP

A

CXR
-will see coal macules
-predilection for upper lungs w/ granular appearance

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9
Q

What are coal macules

A

2-5mm diffuse, small, round, nodular opacities

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10
Q

What is the most sensitive/ specific test for CWP

A

chest CT

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11
Q

What will be seen on PFT for CWP

A

Minimal changes but coal can cause chronic bronchitis

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12
Q

What can CWP progress to

A

Progressive massive fibrosis (PMF)

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13
Q

What is the screening tool used for CWP

A

CXR every 4-5 years unless an abnormal finding is seen… then every 2 years

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14
Q

What is supportive treatment for lung disease

A

Bronchodilators
pulmonary rehab
supplemental O2
smoking cessation

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15
Q

What are complications of CWP

A

Pulmonary HTN
R-sided HF
Respiratory failure
premature death

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16
Q

What is in place to help prevent CWP

A

NIOSH
use of masks (PPE)
Avoid smoking
encourage periodic screening

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17
Q

What cause silicosis

A

silica dust

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18
Q

What activities expose you to silica dust

A

abrasive blasting
foundry wokr
quarry work
tunneling
stone cutting
hydraulic fracturing

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19
Q

Which population is at higher risk for silicosis

A

Males

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20
Q

What are three main form of silicosis

A

Acute
Accelerated
chronic

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21
Q

What causes acute silicosis

A

large volume exposure (high mortality)

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22
Q

When does accelerated silicosis occur

A

after 5-10 years of exposure

23
Q

How does silicosis present

A

Chronic & accelerated is primarily asymptomatic

Acute form = dyspnea, fatigue, weight loss, diffuse bilateral crackles, respiratory failure within 2 years

24
Q

What diagnostic test is preferred with silicosis

25
Why is chest CT preferred for silicosis dx
Helps differentiate from asbestosis helps assess severity/progression
26
What will be seen on CT with silicosis
Egg shell calcification (found in lymph nodes)
27
How do you monitor progression of silicosis
PFTs
28
What is supportive treatment for silicosis
bronchodilators ICS Pulmonary rehab lung transplant
29
What are complications of silicosis
TB and non-TB mycobacterial infections Spontaneous pneumo emphysema cancer pulmonary HTN Respiratory failure premature death
30
What is the best treatment for silicosis
Prevention -industrial interventions -PPE -PFT/CXR -Annual PPD -pneumoccocal/flu vaccines in at risk patients
31
What causes asbestosis
Asbestos
32
Where do you get asbestos from
heat, fire, electricity, and chemically resistant material occupations, passive, and community exposure direct toxic/macrophage activation
33
Which populations are at higher risk for asbestosis
shipyard workers construction worker textile workers boilermakers sheet metal workers HVAC, plumbing, electrical workers
34
How does asbestosis present
primarily asymptomatic *if symptoms present: non-productive cough and clubbing fingers
35
What imaging is preferred for asbestosis
Chest CT
36
What will be seen on chest CT with asbestosis
bilateral, linear reticular opacities (honeycombing) Predilection for lower lobes pleural plaques
37
What are complications from asbestosis
pulmonary HTN R sided HF Respiratory failure premature death lung cancer
38
What lung cancer are people at higher risk for with asbestosis
Mesothelioma Non-small cell lung cancer
39
What preventative measures can be taken against asbestosis
asbestos abatement Annual lung cancer screening Smoking cessation flu/pneumococcal immunizations
40
What is another name for hypersensitivity pneumonitis
Extrinsic allergic alveolitis
41
What are the types of hypersensitive pneumonitis
farmers lung mushroom pickers disease humidifier lung bird fancier lung detergent workers lung
42
When does hypersensitivity pneumonitis present
as an acute illness that occurs 4-8 hours after exposure
43
What symptoms will someone have with hypersensitivity pneumonitis
Fever/chills/ malaise/ cough/ dyspnea/ vomiting
44
What will be found on PE with hypersensitivity pneumonitis
Bibasilar crackles tachycardia tachypnea
45
How do you work up hypersensitivity pneumonitis
CXR CBC (look for left shift) Restrictive pattern on spirometry
46
What are treatments for hypersensitivity pneumonitis
oral steroids if severe avoid further exposure likely occupational change
47
What is more likely to kill someone in a fire, burns or smoke inhalation
smoke inhalation
48
What are the mechanisms of damage from smoke inhalation
impaired oxygenation upper airway thermal burns lower airway chemical injury/physical irritants
49
What are signs of smoke inhalation
fire in an enclosed space singed nasal hair burns on lips deep/full thickness burn to face/neck/upper torso black colored sputum soot around nasal passages
50
What occurs in upper airway injuries
more rapid presentation (18-24hr) lead to tissue edema and inability to clear secretions and airway obstruction inspiratory stridor
51
What causes lower airway injuries
chemical burns - inhaling products of combustion
52
What happens with lower airway injuries
dyspnea, tachypnea, labored breathing, and cyanosis that worsens of 24-72 hours diffuse wheezing and rhonchi on PE
53
What complications occur with lower airway injuries
ARDS (day 1-2) Sloughing of bronchiolar mucosa (day 2-3) Bacterial infection (day 5-7)
54
How do you treat lower airway injury
100% O2 to treat CO poisoning Bronchodilators ET tube Suctioning / chest PT Fluid resuscitation daily sputum cultures

CABS pulmonology (8 decks)

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