Pulmonary Pathophysiology - Environmental and Other Diseases Flashcards
Examples of environmental / occupational lung diseases
Coal workers’ pneumoconiosis
Silicosis
Asbestos related diseases
Byssinosis
Occupational asthma
Types of coal workers’ pneumoconiosis
Simple pneumoconiosis
Progressive massive fibrosis
Clinical features of simple coal workers’ pneumoconiosis
Little change to pulmonary function
May have cough
Mild exertional dyspnoea
Small fall in FEV
Clinical features of progressive massive fibrosis
Less common
Extensive fibrous tissue surrounded by lung destruction
Major pulmonary function impairment
Mixed obstructive and restrictive picture with pulmonary function test
Clinical features of silicosis
Silica particles highly toxic
Generalised interstitial fibrosis
Ranges from mild disease to advanced disease to progressive massive fibrosis
Mild silicosis
Radiological changes but no symptoms
Advanced silicosis
Cough
Severe dyspnoea
Pulmonary function in silicosis
Restrictive pattern
Reduced diffusing capacity
Asbestos related diseases
Asbestosis - diffuse interstitial fibrosis
Bronchial carcinoma
Mesothelioma / other pleural disease
Features of asbestosis
Occurs after heavy exposure
Progressive dyspnoea
Crackles esp at lung bases
Restrictive pulmonary function pattern
Features of pleural related asbestos diseases
Can occur with minimal exposure
Pleural plaques - usually harmless
Can develop mesothelioma many years after exposure
Byssinosis features
Caused by bracts surrounding cotton bol plant
Symptoms worse after period of absence from mill / exposure
Pulmonary function show obstructive patterns
Normal CXR
Symptoms of byssinosis
Dyspnoea
Chest tightness
Wheeze
Cough
After long exposure can develop COPD
Occupational asthma
Hypersensitivity on exposure to allergenic dusts
Eg. flour, printers, fur, feathers
Classification of lung cancer
Small cell lung carcinoma
Non-small cell carcinoma
Features of small cell lung ca
Highly malignant
around 1/3rd of all lung ca
Types of non-small cell lung ca
Squamous carcinoma
Large cell carcinoma
Adenocarcinomas
Squamous cell carcinoma features
Around half of all lung ca cases
Intercellular bridges
Associated with extrinsic Parathyroid hormone secretion
Large cell carcinoma features
Occur in periphery
Around 10% of lung ca cases
Adenocarcinomas
Occur more centrally
More common in females
Often produce mucus
Why does primary TB tend to present in the apex of lung
TB thrives better at higher PO2
Cystic fibrosis genetics
Disease of all exocrine glands
Autosomal recessive
Mutation of CFTR gene - affects Na+ and Cl- transport
Cystic fibrosis diagnosis
Pilocarpine sweat test
Cystic fibrosis signs / symptoms
Excessive thick secretions in lung
Pancreas affected
Small airway mucus plugging
Frequent chest infections
Finger clubbing
