Pneumoconioses, Toxins, Pollution Flashcards
What exposure causes Byssinosis?
chronic exposure to raw, unprocessed cotton
What are symptoms of byssinosis? PFTs?
Symptoms of RAD. Obstructive PFTs
Chronic exposure to raw cotton
What exposure causes Organic Dust Toxic Syndrome?
AKA “Toxic Alveolitis” or “Pulmonary Mycotoxicosis”
hog confinment facilities, incluing grinding.
What exposure causes Metal Fume Fever?
Zinc Oxide, from welding or brazing galvonized metal.
What are symptoms of Metal Fume Fever?
Flu-like symptoms, hours after exposure. Worse after time away from work, such as a weekend.
What exposure causes “Polymer Plume Fever’? What other disease is closely related?
Melting teflon, such as on a heating element.
Works like Metal Fume Fever (Zn-Oxide, welding)
What molecule causes Silo Filler’s Disease?
Nitrogen Oxide (NO2)
What are symptoms of silo filler’s disease?
mild, self-limiting cough, dyspnea, fatigue.
Longer exposures cause asphyxiation, pulmonary edema, BOOP, ARDS.
What exposure causes Ornithosis?
Chlamydia Psittaci.
Ornothosis, AKA Psittacosis)
From birds - owners, pet shops, vets. Parrots and parakeets.
What are symptoms of ornithosis?
blood tinged cough, flu like symptoms
What is treatment for ornithosis?
Doxycycline.
2nd line is azithromycin.
Due to Chlamydia Psittaci.
What are the symptoms of Nylon Flock Worker’s Lung?
ILD
What exposure causes Hydrogen Sulfite exposure?
Sewer gas
What is the treatemnt for hydrogen sulfite exposure?
humidified O2, bronchodilators.
What are symptoms of hydrogen sulfite exposure?
Low dose is irritant, but high dose is asphysant and interferes with oxygen utilization and CNS function.
Exposure causes loss of sense of smell quickly, so prolonged exposure may occur. Smells like rotten eggs.
What is the timeline of acute HP?
Symptoms start in 4-8 hours, last 12-24 hours.
Brief, intense exposure.
What are the CT findings of HP?
Poorly defined micronodules, widespread GGOs with mosaic pattern in upper & middle lung zones.
What are the PFT findings of HP?
Restrictive PFTs and decreased diffusion capacity.
What are the BAL findings of HP?
Lymphocytosis (>65%; normal is 6%), and decreased CD4/CD8 ratio.
What is the most common occupational lung disease worldwide?
Silicosis
What are the CT findings of silicosis?
Egg shell calcifications, calcified lymph nodes, crazy paving (if acute), poorly formed nodules.
What is the buzz-word histology of silicosis? What is the other ddx?
- Bire-fringent. Ddx: Talc
- Acute has alveolar proteinosis.
What does acute silicosis progress to?
Progressive Massive Fibrosis
What are the PFT findings of silicosis?
restrictive, diffusion capacity decreased
Silicosis causes increased risk for what other two diseases?
TB, lung cancer
What is the histology of coal worker’s pneumoconoisis?
black nodules & lymph nodes, centrilobular emphysema, coal-laden alveolar macrophages.
What is the increased risk for lung cancer with coal-worker’s pneumoconoisis?
None
What are the two major types of asbestos fibers? Which is worse?
- Crocidolite is most fibrogenic and carcinogenic.
- Chrysotile (serpentine) is not as bad.
What is the histology of asbestos?
Ferruginous bodies, looks like barbells. Coated with iron and mucopolysaccharide.
Are asbestos pleural plauqes on the parietal or visceral pleura?
Parietal pleura
How long after asbestos exposure do pleural plaques develop?
> 20 years
Does asbestos exposure increased you risk for:
Lung cancer?
COPD?
TB?
Increased risk for lung cancer, multiplicative with tobacco smoking. No risk for TB or COPD.
What are the CT findings of mesothelioma?
Circumferential, unilateral pleural thickening
What exposure gives you beryllium exposure?
flourescent light manufacturing or aerospace industry
How is Chronic Berylium Disease diagnosed?
- beryllium sensitivity on BAL CD4 cells
- Lymphocyte proliferate response
What is treatment for Chronic Beryllium Disease?
steroids
What disease does Chronic Beryllium Disease look like, in terms of disease progression?
Sarcoidosis
Buzzword: drill bits, metal hardening
Cobalt with giant interstitial pneumonitis or hard metal lung disease
Buzzword: nasal septum perforation or lesions on fingers
Chrome exposure. Ddx with nasal perforation is cocaine and blastomycosis
Buzzword: catalytic converter or jewelry manufacturers with asthma
Platinum (type 1 hypersensitivity)
Buzzword: Garlic odor on breath
selenium
Buzzword: garlic/fish odor and massive hemolysis
arsine gas
Buzzword: methamphetamine production
ammonia or phosgene gas
Buzzword: bone necrosis, deep burns on contact
phosphorus
Buzzword: refining nickel with diffuse ILD
Nickel carbonyl
Buzzword: hypocalcemia and severe burns
hydroflouric acid
Buzzword: oil industry and rotten egg smell:
hydrogen sulfide H2S)
Buzzword: Pathology looks like granulomas and sarcoid, but history has occupational exposure
berrylium
Buzzword: confused, elderly, in home, in winter
carbon monoxide.
