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First Aid 2014 > RESPIRATORY: 606 - 607 > Flashcards

RESPIRATORY: 606 - 607 Flashcards

1
Q

What are pneumoconioses?

A

Chronic occupational exposure to small fibrogenic particles that leads to interstitial fibrosis

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2
Q

Give 4 examples of pneumoconioses.

A
  1. Asbestosis
  2. Coal workers’ pneumoconiosis
  3. Silicosis
  4. Berylliosis
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3
Q

What does pneumoconiosis increase the risk of?

A
  1. Cor pulmonale

2. Caplan syndrome (rheumatoid arthritis and pneumoconioses with intrapulmonary nodules)

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4
Q

What professions are associated with asbestosis?

A

Shipbuilding, roofing, plumbing

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5
Q

Describe the plaques found in asbestosis.

A

Ivory white, calcified pleural plaques

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6
Q

Asbestosis is associated with increased risk of what 2 cancers.

A

Bronchogenic carcinoma&raquo_space; mesothelioma

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7
Q

Does asbestosis tend to affect the upper or lower lobes?

A

Lower

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8
Q

What do asbestos (ferruginous) bodies look like?

A

Golden-brown fusiform rods resembling dumbbells; has iron deposits

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9
Q

What accumulates in macrophages in coal workers’ pneumoconiosis?

A

Carbon

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10
Q

Are the lung in coal workers’ pneumoconiosis shrunken or swollen?

A

Shrunken (from inflammation and fibrosis)

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11
Q

What is another name for coal workers’ pneumoconiosis?

A

Black lung disease

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12
Q

Does coal workers’ pneumoconiosis tend to affect the upper or lower lobes?

A

Upper

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13
Q

What is anthracosis?

A

Asymptomatic condition found in many urban dwellers exposed to sooty air –> collection of carbon laden macrophages in the lung from mild exposure

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14
Q

What is silicosis associated with?

A

Foundries, sandblasting, mines

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15
Q

Describe the pathophysiology of silicosis.

A

Macrophages respond to silica and release fibrogenic factors leading to fibrosis

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16
Q

Why is silicosis thought to relate to increased risk of TB?

A

Silica may disrupt phagolysosomes and impair macrophages increasing susceptibility to TB infection

17
Q

What is the only pneumoconiosis associated with an increased risk of TB?

A

Silicosis

18
Q

Does silicosis tend to affect the upper or lower lobes?

A

Upper

19
Q

Describe the hilar lymph nodes in silicosis.

A

“Eggshell” calcification

20
Q

What two occupations are at increased risk of berylliosis?

A
  1. Beryllium miners

2. Workers in aerospace industry

21
Q

In what ways is berylliosis similar to sarcoidosis?

A

Both present with noncaseating granulomas in the lung, hilar lymph nodes, and systemic organs

22
Q

Berylliosis increase the risk of what?

A

Lung cancer

23
Q

Describe the pathophysiology in neonatal respiratory distress syndrome.

A

Surfactant deficiency –> increased surface tension –> alveolar collapse

24
Q

What is predictive of neonatal respiratory distress syndrome as a lab test?

A

Lecithin:sphingomyelin ratio < 1.5 in amniotic fluid

25
Q

Why is there a risk of patent ductus arteriosus in neonatal respiratory distress syndrome?

A

Persistently low O2 tension

26
Q

Therapeutic supplemental O2 for NRDS can result in what sort of damage?

A

Free radical damage:

  1. Retinopathy of prematuriy
  2. Bronchopulmonary dysplasia
27
Q

How can we treat neonatal respiratory distress syndrome?

A
  1. Maternal steroids before birth

2. Artificial surfactant for infant

28
Q

What are 3 risk factors for NRDS?

A
  1. Prematurity
  2. Maternal diabetes
  3. C-section delivery
29
Q

Why is maternal diabetes a risk factor for NRDS?

A

Increased sugars –> increased fetal insulin –> insulin inhibits surfactant production

30
Q

Why is C-section delivery a risk factor for NRDS?

A

Decreased release of glucocorticoids

With a normal delivery, there is release of glucocorticoids (stress hormone) which increases production of surfactant and causes already made surfactant to be released by type II pneumocytes into the lung

31
Q

What are some of the clinical features of NRDS?

A
  1. Increased respiratory effort after birth
  2. Tachypnea with use of accessory muscles
  3. Grunting
  4. Hypoxemia with cyanosis
  5. Diffuse granularity of lung on X ray
32
Q

What are some of the causes of acute respiratory distress syndrome?

A
  1. Trauma
  2. Sepsis
  3. Shock
  4. Gastric aspiration
  5. Uremia
  6. Acute pancreatitis
  7. Amniotic fluid embolism
33
Q

Describe the pathophysiology in acute respiratory distress syndrome.

A

Diffuse alveolar damage –> increase alveolar capillary permeability –> protein-rich leakage into alveoli and noncardiogenic pulmonary edema –> eventual formation of intra-alveolar hyaline membrane

34
Q

What are 2 problems resulting from the formation of hyaline membrane?

A
  1. Thickened diffusion membrane leads to hypoxemia and cyanosis
  2. Membranes are sticky and increase the surface tension of the air sacs leading to diffuse collapse
35
Q

What is the initial damage of ARDS due to?

A

Activation of neutrophils induces protease mediated and free radical damage to type I and type II pneumocytes

Also activates coagulation cascade

36
Q

Compare FEV1/FVC in normal vs. obstructive vs. restrictive lung disease.

A

Normal = 80%
Obstructive < 80%
Restrictive > 80%

First Aid 2014 (24 decks)

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