Occupational Medicine

Question 1

Mention X-ray findings in occupational lung diseases

Answer 1

They differ in site, size & shape:
In silicosis, upper half of lung shows rounded small opacities
In asbestosis lower half of lung shows irregular opacities, tenting of diaphragm
In PMF, there are large opacities
Byssinosis: inc bronchovascular markings

Question 2

Mention examples of biological monitoring

Answer 2

Blood lead or urine dALA, urine mercury, CBC for X-ray workers

Question 3

Maximum noise exposure should be….m while the first affected zone of audiometry is…..

Answer 3

85 dB
4000-6000 Hz

Question 4

Mention acute effects of ionizing radiation exposure

Answer 4

1. Severe watery diarrhea w/mucus threads
2. Anemia, leucopenia, thrombocytopenia
3. Abortion
4. Cataract

Question 5

Mention medical measures for protection in ionising radiation exposure

Answer 5

1. Pre-employment exam including CBC
2. Periodic medical exam including CBC /6m, & early detection of skin & other system affection
3. Leaded aprons
4. Periodic monitoring of personal exposure through personal dosimeters as badge films

Question 6

Mention accepted radiation exposure for each population group

Answer 6

Occupational 5 Rem/year, not exceeding half this amount in 3 months or in whole period of pregnancy
2.5 Rem for general population

Question 7

IR rays cause…..while UVR cause
PPE is……

Answer 7

Posterior polar cataract
Protective goggles & protective aprons

Question 8

Mention acute effects of decompression sickness

Answer 8

Bends, itching, pulmonary air embolism, asphyxia, abdominal colic, focal CNS lesions may be temporary or permennat
Delayed: aseptic bone necrosis

Question 9

The most important heat loss mechanism is…..
Heat balance equation is…..
Evaluation of heat stress is by….

Answer 9

Evaporation
M+/-R+/-C-E
Wet bulb globe thermometer

Question 10

Mention guidelines for workers exposed to heat

Answer 10

Dec earing of fatty diet to dec caloric intake thus maintain heat balance
Compensate for salt & water loss in sweat by eating salty meals & inc fluid intake

Question 11

Heat rash is ttt by…..

Answer 11

Frequent cleaning of skin, keratolytic lotions (5% salicylic acid)

Question 12

The earliest manifestation of water depletion heat exhaustion is…..

Answer 12

Thirst & dry tongue

Question 13

Mention the essential triad of rapid diagnosis

Answer 13

1. Hyperpyrexia (rectal temp 40.6degC)
2. Loss of consciousness
3. Red hot dry skin

Question 14

Mention TTT of heat stroke

Answer 14

It is a medical emergency, prognosis depends on rapid cooling to reach at least 38.9degC within 1 hr, then gradual cooling
This is done by water spraying & air current by fans & supportive & symptomatic measures
Never use ice cold water

Question 15

Acclimatization is mainly by…..&…..

Answer 15

ACTH & ADH

Question 16

Mention clinical effects of inorganic lead exposure

Answer 16

Blue-grey lead line in gum d.t. lead sulfide accumulation, abdominal colic, constipation vomiting.
Lead nephropathy & renal hypertension
Spontaneous abortion
Lead encephalopathy in children (if organic causes psychosis)
Lead anemia
Foot & wrist drop

Question 17

Mention main clinical findings in mercury exposure

Answer 17

Acute pneumonitis
Gingivitis & teeth loss
Renal damage
Neuropsychiatric changes (erethism) & tremors
Sensory & motor changes

Question 18

Mention sources of:
1. Cadmium
2. Chromium

Answer 18

1. Electroplating, welding, some alloys
2. Tanning of leather, manufacture of pigments & Portland cement & alloys

Question 19

Mention main clinical findings in cadmium exposure

Answer 19

Renal impairment, osteomalacia of the bone & severe aches (Itai Itai disease), bronchitis & focal emphysema

Question 20

Mention main clinical findings in cadmium exposure

Answer 20

Skin: Chrome holes of hands & forearms, Dermatitis
Respiratory tract irritation: ulceration of nose & throat with crusting of nose, perforated nasal septum, inc incidence of lung cancer & nasal cavity

Question 21

Mention the simple asphyxiants

Answer 21

Methane, butane, nitrogen, helium

Question 22

Mention effects of (1) arsine, (2)nickel carbonyl

Answer 22

1. RBCs destruction leading to anemia & jaundice
2. Causes severe pulmonary irritation

Question 23

Mention first aid measures for occupational gas exposure

Answer 23

Remove victim from source of fumes to fresh air
Support them & encourage normal breathing
Monitor vital signs till transfer to hospital

Question 24

Mention first aid measures for pesticide exposure

Answer 24

1. Protect yourself by waering appropriate protective clothing & equipment esp if pesticide is absorbed through skin
2. If pesticide has been inhaled remove person to fresh air, if eye exposure clean for 15 min w/ running water
3. If conveulsions—ER & atropine
4. Each pesticide antidote can be known from safety data sheet

Question 25

In……, doxycyline is prophylactic while in……spraying formaldehye is prophylactic

Answer 25

Leptospirosis
Histomplasmosis (contaminated surfaces in farms)

Question 26

Mention diseases caused egg shell appearance on X-ray

Answer 26

Sarcoidosis, TB, silicosis

Question 27

Mention CCC of silicosis & asbestosis

Answer 27

Both: bronchogenic carcinoma & corpulmonary
S: TB, A: mesothelioma

Question 28

Silica can be substituted by…..

Answer 28

Corundum

Question 29

PMF occurs when…….while Caplan syn is…..

Answer 29

Inhaled carbon dust is mixed with silica dust
Nodulat opacity in rt lung + rheumatoid arthritis

Question 30

Mention causes of extrinsic allergic alveolitis

Answer 30

1. Farmer’s lung caused by micropolyspora faeni & thermoactinmyces vulgaris from mouldy hay
2. Bagassosis: theractinomyces sacchari from wood & paper industry

Question 31

Mention a specific neasure in extrinsic allergic alveolitis

Answer 31

Spraying 1% propionic acid

Question 32

……causes obstructive airway disease, exposure is in…..esp in…..

Answer 32

Byssinosis
Cotton industry
Carding

Question 33

Most commonly affected body parts by bad ergonomics are…..

Answer 33

Arms & back