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CABS pulmonology > occupational lung disease > Flashcards

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

A

Chest CT

25
Q

Why is chest CT preferred for silicosis dx

A

Helps differentiate from asbestosis

helps assess severity/progression

26
Q

What will be seen on CT with silicosis

A

Egg shell calcification (found in lymph nodes)

27
Q

How do you monitor progression of silicosis

A

PFTs

28
Q

What is supportive treatment for silicosis

A

bronchodilators
ICS
Pulmonary rehab
lung transplant

29
Q

What are complications of silicosis

A

TB and non-TB mycobacterial infections

Spontaneous pneumo
emphysema
cancer
pulmonary HTN
Respiratory failure
premature death

30
Q

What is the best treatment for silicosis

A

Prevention
-industrial interventions
-PPE
-PFT/CXR
-Annual PPD
-pneumoccocal/flu vaccines in at risk patients

31
Q

What causes asbestosis

A

Asbestos

32
Q

Where do you get asbestos from

A

heat, fire, electricity, and chemically resistant material

occupations, passive, and community exposure

direct toxic/macrophage activation

33
Q

Which populations are at higher risk for asbestosis

A

shipyard workers
construction worker
textile workers
boilermakers
sheet metal workers
HVAC, plumbing, electrical workers

34
Q

How does asbestosis present

A

primarily asymptomatic

*if symptoms present: non-productive cough and clubbing fingers

35
Q

What imaging is preferred for asbestosis

A

Chest CT

36
Q

What will be seen on chest CT with asbestosis

A

bilateral, linear reticular opacities (honeycombing)

Predilection for lower lobes

pleural plaques

37
Q

What are complications from asbestosis

A

pulmonary HTN
R sided HF
Respiratory failure
premature death
lung cancer

38
Q

What lung cancer are people at higher risk for with asbestosis

A

Mesothelioma
Non-small cell lung cancer

39
Q

What preventative measures can be taken against asbestosis

A

asbestos abatement
Annual lung cancer screening
Smoking cessation
flu/pneumococcal immunizations

40
Q

What is another name for hypersensitivity pneumonitis

A

Extrinsic allergic alveolitis

41
Q

What are the types of hypersensitive pneumonitis

A

farmers lung
mushroom pickers disease
humidifier lung
bird fancier lung
detergent workers lung

42
Q

When does hypersensitivity pneumonitis present

A

as an acute illness that occurs 4-8 hours after exposure

43
Q

What symptoms will someone have with hypersensitivity pneumonitis

A

Fever/chills/ malaise/ cough/ dyspnea/ vomiting

44
Q

What will be found on PE with hypersensitivity pneumonitis

A

Bibasilar crackles
tachycardia
tachypnea

45
Q

How do you work up hypersensitivity pneumonitis

A

CXR
CBC (look for left shift)
Restrictive pattern on spirometry

46
Q

What are treatments for hypersensitivity pneumonitis

A

oral steroids if severe
avoid further exposure
likely occupational change

47
Q

What is more likely to kill someone in a fire, burns or smoke inhalation

A

smoke inhalation

48
Q

What are the mechanisms of damage from smoke inhalation

A

impaired oxygenation

upper airway thermal burns

lower airway chemical injury/physical irritants

49
Q

What are signs of smoke inhalation

A

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
Q

What occurs in upper airway injuries

A

more rapid presentation (18-24hr)

lead to tissue edema and inability to clear secretions and airway obstruction

inspiratory stridor

51
Q

What causes lower airway injuries

A

chemical burns - inhaling products of combustion

52
Q

What happens with lower airway injuries

A

dyspnea, tachypnea, labored breathing, and cyanosis that worsens of 24-72 hours

diffuse wheezing and rhonchi on PE

53
Q

What complications occur with lower airway injuries

A

ARDS (day 1-2)
Sloughing of bronchiolar mucosa (day 2-3)
Bacterial infection (day 5-7)

54
Q

How do you treat lower airway injury

A

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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