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Clinical Medicine > Occupational Pulmonary Disease > Flashcards

Occupational Pulmonary Disease Flashcards

1
Q

What is occupational pulmonary disease

A

Can be acute or chronic
1. Inhalation of noxious substance found in the workplace
2. Smoking often accompanies exposure

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2
Q

How can occupation pulmonary disease be classified into

A
  1. Pneumoconioses
  2. Hypersensitivity pneumonitis
  3. Obstructive airway disorders
  4. Toxic lung injury
  5. Lung cancer
  6. Plural disease
  7. Other occupational pulmonary disease
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3
Q

How does occupational pulmonary disease occur (steps 1 + 2)

A
  1. Particles over 10 microns in diameter deposit in the bronchi and bronchioles and removed by mucociliary clearance, expectorated, or swallowed
  2. Some of the smaller particles reach the alveoli and are inhaled/exhaled
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4
Q

How does occupational pulmonary disease occur (steps 3 +4)

A
  1. Macrophages in alveoli ingest some inhaled particles
  2. Other migrate into the intertitium of the lung
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5
Q

What is pneumoconiosis (occupational pulmonary disease)

A

Chronic fibrotic Lung disease
1. Inhalation of inert inorganic dust
2. Range from asymptomatic to severely debilitating, life shortening disorders
*coal workers pneumoconiosis
*silicosis
*asbestosis

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6
Q

What are the three main types of pneumoconiosis and tx

A
  1. Asbestosis
  2. Silicosis
  3. Coal workers pneumoconiosis
    Tx = supportive
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7
Q

What is coal workers pneumoconiosis

A
  1. Inhaled coal dust ingested by alveolar macrophages will
    *create coal macules 2-5mm in diameter
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8
Q

How will coal workers pneumoconiosis (CWP) show on X-ray

A
  1. Appear as small diffuse opacities
  2. More prominent in upper lung
    *simple CWP and complicated CWP
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9
Q

What is simple CWP

A

Largely asymptomatic
1. Unimpressive PFT issues

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10
Q

What is complicated CWP “progressive Massive Fibrosis”

A
  1. Conglomeration and contraction in upper lung zones
  2. Radiographic ally similar to complicated silicosis
  3. Increased gastric cancer incidence
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11
Q

What is caplan syndrome (complicated CWP)

A
  1. Necrobiotic rheumatoid nodules in periphery of lungs in those with RA
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12
Q

What is silicosis

A
  1. Extensive prolonged inhalation of free silica
    *carcinogenic
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13
Q

What was the major cause of death of workers exposed to silica dust

A

Silicosis
1. Sandblasters
2. Stone cutting
3. Polishing and sharpening of metals

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14
Q

How does silicosis happen

A
  1. Silica particles are inhaled and ingested by alveolar macrophages
    *0.3 to 0.5 microns
  2. Form small rounded opacities throughout the lung fields
  3. Calcification of periphery of the hilar lymph nodes
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15
Q

How will silicosis show on the X-rays

A

Egg-shell calcification

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16
Q

What is simple silicosis

A

Asymptomatic, no issues found with PFT

17
Q

What is complicated silicosis

A
  1. Large conglomerate densities in upper lung
  2. Dyspnea
  3. Obstructive and restrictive pulmonary dysfunction
  4. Increased chance of tuberculosis
18
Q

What is asbestosis

A
  1. Nodular interstitial fibrosis
19
Q

What is asbestos used in

A
  1. Insulation
  2. Construction materials
  3. Automotive brake linings
20
Q

What type of workers are effected by asbestosis

A
  1. Mining or processing asbestos
  2. Shipbuilding, shipyard
  3. Construction
  4. Pipe fitting
21
Q

How will asbestosis show on a X-ray

A

Nodular interstitial fibrosis from heavy, prolonged exposure
1. Fibrosis will spread beyond the peribronchiolar location
2. Eventually end in honeycomb lung
3. More severe in lower zones of the lung

22
Q

What are the S/Sx of asbestosis

A
  1. Known chronic exposure, at least 15+ years after prolonged exposure
  2. Progressive dyspnea
  3. Inspiratory crackles
  4. Clubbing
  5. Cyanosis
23
Q

What are the diagnostic studies to complete for asbestosis

A
  1. PFT = RLD
  2. CXR
    *linear streaking at bases
    *opacities or various shapes/sizes
    *honeycombing if advanced
    *pleural calcifications
  3. CT
    *best for visualizing parenchymal fibrosis and plaques
24
Q

What are the complications of asbestosis

A
  1. Progressive fibrosis
  2. Pulmonary HTN
  3. Mesothelioma
    *cancer of the pleural will encase the lungs
  4. Pleural effusion
  5. Pleural plaques
25
Q

What is berylliosis

A
  1. Inhalation of beryllium dusts, vapors, or it’s compounds or implanting of the substance in the skin
26
Q

What is beryllium

A

Alkaline earth metal
*metallic element used in many industries
*car manufacturing
*computers
*golf clubs
*electrical equipment

27
Q

What is the treatment for ALL pneumoconioses

A
  1. Supportive tx
    *no cure

Clinical Medicine (164 decks)

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