Pulmonary and Cardiology

Question 1

Spirometry Flow Volume Loop

Answer 1

Directly recorded from machine

Question 2

FVC

Answer 2

after maximal inhalation, it is the total amount of air expelled.

it is the highest point on the Flow Volume Loop

Question 3

FEV1

Answer 3

the amount of air forcefully exhaled during the first second of exhalation

Pearl: if FEV1 is not less than FVC, then there is a mistake

Question 4

How is asthma diagnosed

Answer 4

-Spirometry with Bronchodilation
Improvement in FEV1 > 200mg or 5%
-Bronchoprovocation (methacholine challenge)
dose of methacholine will cause a 20% fall in FEV1

Question 5

Types of Occupational Asthma

Answer 5

Allergic
-isocyanates is a common one
-requires prior exposure
-ex: mice, latex, 
Irritant
RADS
-huge irritant exposure
-immediate sensitivity to everything
-usually seen after smoke inhalation
-sometimes after 3-5 years it will go away on its own

Question 6

Byssinosis

Answer 6

• asthma-like condition caused by exposure to cotton dust

- Monday Morning Fever: tolerance develops over the week

Question 7

OSHA Cotton Dust Standard

Answer 7

because of Byssinosis
this is why NIOSH certifies spirometry techs
Monitors workers with spirometry

Question 8

Hypersensitivity Pneumonitis is what type of allergic reaction

Answer 8

happens in response to inhaled antigen in previously sensitized people

***Type III Hypersensitivity reaction

Question 9

Pneumoconiosis is due to the inhalation of what?

Give examples

Answer 9

inhalation of dust

B CHAOS
Berylliosis
Coal worker's Pneumoconiosis
Hard metal Disease
Asbestosis
Others
Silicosis

Question 10

Silicosis causes what type of lung disease.

Answer 10

Pneumoconiosis

symptoms vary and occurs over many years

Question 11

What is Black Lung

Answer 11

Coal Worker’s Pneumoconiosis

Silicosis in a Coal Miner

Question 12

What causes metal fume fever

Answer 12

Zinc or Copper
Welding on Galvanized Steel
NO long-term effects

Question 13

Give an example of Bronchiolitis Obliterans

Answer 13

Popcorn Worker’s Lung

can require a lung transplant

Question 14

OSHA CFR Respiratory Standard

Answer 14

ASHA 29 CFR 1910.134

Question 15

What is required by the OSHA Respiratory Protection Standard

Answer 15

MUST complete a medical questionnaire BEFORE initial fit testing

Question 16

What findings are seen on X-ray with Silicosis

Answer 16

X-ray shows diffuse small opacities, over time when progressive, smaller opacities may all grow together to form larger opacities

Question 17

Give 2 examples of things that cause Hypersensitivity Pneumonitis

Answer 17

aka Farmer’s lung (actinomycetes in hay/mold) or Pigeon breeders lung

Isocyanates (foam industry)

Question 18

What substance causes nonatheromatous ischemic heart disease

Answer 18

Organic Nitrates

Question 19

Name 2 things that cause peripheral arterial occlusive disease

Answer 19

Lead and Arsenic

Question 20

explain CV effect of workers exposed to nitrates

Answer 20

Causes angina, MI and CV death, thought to be due to rebound vasospasm overnight and weekends when workers are home and not exposed

Question 21

Name the substance used to decaffeinate coffee that converts to CO

Answer 21

Methylene Chloride

Question 22

How does exposure to CO affect the heart

Answer 22

decreased O2 to the heart lowers the threshold for ventricular fibrillation

Question 23

Chronic exposure to Carbon Disulfide (rayon industry) can cause what effect on the CV system

Answer 23

• retinal micro aneurysms

- CAD