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Clinical Medicine - Pulm > Pneumoconiosis and Sarcoidosis > Flashcards

Pneumoconiosis and Sarcoidosis Flashcards

1
Q

Define sarcoidosis

A

Multisystem disease characterized by noncaseating granulomas

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2
Q

Etiology of sarcoidosis

A

Unknown

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3
Q

Epidem: when does sarcoidosis peak?

A

Young adults

Ages > 60 years

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4
Q

What is the pathophy of sarcoidosis?

A

T lymphocytes initiate alveolitis –> leads too macrophage, mast cell, monocytes, and fibroblast recruitment –> leads to non-caseating granulomas

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5
Q

Sarcoidosis restrictive or obstructive?

A

Restrictive

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6
Q

What are the signs/symptoms of sarcodosis?

A

Non productive cough, dyspnea, rhonchi, wheezing, lymphadenopathy

Cutaneous: erythema, maculopapular rash

Ocular signs: blindness, chronic dry eyes

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7
Q

What is needed to dx sarcoidosis?

A

Clinical presentation + biopsy

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8
Q

What are some CXR results of sarcoidosis?

A

Hilar, paratracheal lymphadenopathy

Upper lobe, mainly, bilateral, infiltrates

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9
Q

What is the main treatment of sarcoidosis?

A

Watch it!

Then can use glucocorticoids

  • -> topical for single organ
  • -> oral for multiorgan
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10
Q

What if a patient is intolerant to steroids? How would you then treat a patient with sarcoidosis?

A

Hydroxycholroquine for skin (contraindicated in the eye)

Methotrexate

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11
Q

Define pneumoconioses asbestosis

A

Diffused pulmonary interstitial fibrosis occurring in asbestos exposed workers/bystanders/community

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12
Q

Etiology of pneumoconioses asbestosis

A

Asbestos fibers

–> amphibole type is more toxic than chrysotile

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13
Q

What do asbestos fibers cause?

A

trigger alveolitis –> inflammation –> scarring and fibrosis –> dec. pulmonary function

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14
Q

Presentation of pneumoconioses asbestosis

A

Chest pain

Productive cough

DOE

Rales

Clubbing

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15
Q

What diagonistic tests to run and what do they show?

A

CXR - pleural plaques, calcification in lower lung fields, pleural effusions

PFTs - Dec FVC and FEV1/FVC ratio, dec TLC, dec. DLCO

HRCT - Lower zone fibrosis, pleural thickening

Lung Biopsy - parenchymal asbestos bodies

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16
Q

Treatment for pneumoconioces asbestosis

A 
NO EFFECTIVE TX
Stop smoking
Bronchodilator if there is co-existing COPD
Pulm rehab
O2 therapy
Lung transplant
17
Q

Complications of asbestos?

A
  1. Cor pulmonale
  2. Malignancy (Lung cancer mc…then mesothelioma)
  3. Pulmonary HTN
  4. Right sided heart failure
18
Q

Coal Worker’s Pneumoconiosis (CWP): what is the histologic hallmark?

A

Coal macules

–Areas of focal deposition of coal dust and pigment-laden macrophages

19
Q

What are complications of coal worker’s pneumoconiosis

A
  1. Progressive massive fibrosis
  2. Caplan syndrome
    - -> Rhematoid arthritis w/ pneumoconiotic nodules
  3. T.B
  4. Cancer
    - -> Squamous cell
20
Q

When do miners get CXR’s?

A

Get one as soon as they are hired and then every 5 years

21
Q

What is the most common form of crystalline silica?

A

Quartz

22
Q

What diagnostic test is needed to dx pneumoconioses silicosis?

A

CXR

–> can get CT if it is progressive massive fibrosis

23
Q

What do PFT results look like in pneumoconioses silicosis

A

Mixed pattern of obstructive and restrictive

24
Q

What test is indicated in all persons w/ silicosis?

A

PPD

25
Q

Treatment of pneumoconioses silicosis

A
  1. Prevent further exposure
  2. Quit smoking
  3. Immunize
  4. Corticosteroids benefit in acute silicosis
  5. Consult Pulmonologist
26
Q

Pathophysiology of pneumoconioses: chronic beryllium disease

A

T-cell proliferation –> proinflammatory cytokines –> non-caseating granulomatous inflammation

27
Q

What are the 2 things needed to Dx CBD?

A
  1. Evidence of sensitization to beryllium

2. Presence of compatible lung pathology

28
Q

Treatment for Chronic Beryllium Disease

A
  1. Refer to pulmonologist
  2. Symptomatic tx
  3. Corticosteroids
  4. Methotrexate considered if corticosteroids fail

Clinical Medicine - Pulm (13 decks)

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