Pneumoconiosis and Vascular Disease 1

Question 1

how does ______ increase the risk of developing pulmonary TB?

Answer 1

silicosis;

- the crystalline silica inhibits the ability of pulmonary macrophages to kill the phagocytosed mycobacteria

Question 2

what are some non cariogenic causes of pulmonary edema?

Answer 2

• ARDS
• high altitude
• neurogenic
• pulmonary embolism

Question 3

what are some secondary causes to hypoxia that can lead to pulmonary thromboembolism

Answer 3

• atelectasis
• blood flow redirected to the normally hypoventilated areas of the lung g
• right to left shunt

Question 4

atheroma are seen in what sized arteries in pulmonary HTN

Answer 4

large

Question 5

fibrous scar and massive fibrosis with impaired pulmonary function is seen in what type of CWP?

Answer 5

complicated CWP

Question 6

what occupations are at risk for silicosis?

Answer 6

• mining
• sandblasting
• stonecutting
• ceramics

Question 7

plexiform lesions involve _______ sized arteries and are common in primary/secondary pulmonary HTN

Answer 7

smaller sized arteries;

more common in PRIMARY pulmonary HTN

Question 8

what is the pathogenesis of the mutation in BMPR gene in primary cause of pulmonary HTN

Answer 8

• mutation causes extensive proliferation of smooth muscle

- normally, BMPR binds to TGF beta pathway ligands and INHIBITS smooth muscle proliferation

Question 9

what is required for a pulmonary infarct to occur?

Answer 9

end artery occlusion AND cardiovascular compromise

Question 10

a construction worker installing insulation is at risk for developing what lung disease?

Answer 10

asbestosis

Question 11

mesothelioma can be caused by ________. describe what mesothelioma looks like grossly

Answer 11

asbestosis;

thick white pleural tumor tissue that surrounds the lung (like pleura) with normal parenchyma inside

Question 12

asbestos is a risk factor for ______ carcinoma and ________

Answer 12

bronchogenic carcinoma and mesothelioma (mesothelioma involves plaques in the pleura)

Question 13

describe the histopathological side of an asbestos body

Answer 13

• beading and knobbed ends (brown in color)

Question 14

pulmonary HTN is secondary to ______

Answer 14

↓ cross sectional area of blood flow: COPD, recurrent pulmonary emboli or heart disease such as mitral stenosis and L → R shunt

Question 15

pulmonary hypertension is defined as when the mean PA reaches ______

Answer 15

at least 1/4 of the systemic pressure

Question 16

_______ play a central role in the progression of pneumoconiosis

Answer 16

alveolar macrophages: cause tissue injury by releasing enzymes and free radicals AND the secrete growth factors for fibroblast proliferation

Question 17

sudden death in a saddle embolism can be due to _____ or _____

Answer 17

hypoxia or right heart failure

Question 18

what dusts are fibrogenic?

Answer 18

• asbestos

- silica

Question 19

what would you expect to see in the medium sized arteries in pulmonary HTN?

Answer 19

medial wall smooth muscle hypertrophy

Question 20

collagenous bundles surrounded by macrophages is an histopathological feature of _______ (occupational lung disease)

Answer 20

silicosis

Question 21

what are the three subtypes of coal worker’s pneumoconiosis

Answer 21

• anthracosis
• simple CWP
• complicated CWP

Question 22

simple CWP is characterized by ___________

Answer 22

macules and nodules which are aggregates of dust-laden macrophages
very few symptoms

Question 23

primary cause of pulmonary HTN involves a germline mutation in _________

Answer 23

BMPR type 2 (bone morphogenetic protein receptor)

Question 24

what are the 3 most common caucuses of pneumoconiosis

Answer 24

• asbestosis
• silicosis
• coal workers pneumoconiosis

pneumoconiosis is lung diseases secondary to inhalation of mineral dusts and organic/inorganic particulate

Question 25

patient is asymptomatic and histology shows carbon pigment accumulation along the lymph nodes. What is the diagnosis?

Answer 25

anthracosis

Question 26

what are the components of asbestos bodies?

Answer 26

asbestos fibers complexed with protein and iron

iron is from the macrophage ferritin

Question 27

a stonecutter develops _______ and so he is at increased risk for developing __________

Answer 27

silicosis;

↑ risk of pulmonary TB