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CP3 Medicine > RESPIRATORY - Occupational Lung diseases > Flashcards

RESPIRATORY - Occupational Lung diseases Flashcards

1
Q

What is asbestos

A

Mix of silicates of Fe,Mg,Ni,Cd,Al

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2
Q

Who gets asbestos exposure

A

Patients over age 50

Who worked in building industry /shipyardsd before 1960’s

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3
Q

What is the longest latent period for asbestos exposure

A

Up to 50 years

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4
Q

What is the risk of asbestos disease proportional to?

A

Intensity of exposure

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5
Q

What are Asbestos body

A

Markers of asbestos exposure histologically

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6
Q

How can asbestos bodies be seen?

A

Histologically after a lung biopssies

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7
Q

When do pleural plaques occur?

A

After light exposure to asbestos

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8
Q

Sx pleural plaques

A

Usually asymp

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9
Q

Ix findings pleural plaques (3)

A

Mild restrictive deficit on spiromertry
Pleural thickening
Calcification CXR

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10
Q

Are pleural plauques progressive

A

No

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11
Q

Def diffuse pleural thickening

A

affects > ¼ of the pleural surface

Caused by more heavy exposure

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12
Q

PS diffuse pleural thickenings

A

Restrictive deficits

Effort dyspnoea

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13
Q

Are diffuse pleural thickenings progressive?

A

Yes

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14
Q

Onset mesothelioma

A

After light asbestos exposure

20-40y after exposure

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15
Q

PS mesothelioma + CXR findings (3)

A

Pleuritic chest pain
Increasing dyspnoea
Unilateral pleural effusion on CXR

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16
Q

Prognosis mesothelioma

A

not good

med survival 2y from diagnosis

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17
Q

Onset absestosis

A

By heavy exposure

5-10 years from exposure to diagnosis

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18
Q

PS asbestosis + CXR fingins

A

Progressive dyspnoea

Diffuse bilateral streaky strokes on CXR w/ honey combing

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19
Q

Prognosis asbestosis

A

Poor

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20
Q

Which patients can obtain occupational compensation? (4)

A

Bilateral diffuse pleural thickening
Mesothelioma
Asbestos related bronchial carcinoma
Asbestosis

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21
Q

Which other ca can be caused by asbestos exposure

A

Asbestos related carcinoma of the bronchus

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22
Q

What is pneumoconiosis and what is it caused by

A

Disease of the lungs caused by inhalaltion of dusts,, particularly coal

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23
Q

pathology pneumococoniosis

A

Dust = toxic to macrophages so = local inflammatory response

If it becomes chronic –> fibrosis –> restrictive lung defects

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24
Q

What is the risk of developing coal workers pneumoconiosis related to

A

Degree of exposure to the dust

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25
Q

Def simple coal workers pneumoconiosis

A

Small nodules (2-5mm) on CXR - not assoc w/ any clinically signif impairment of resp fct

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26
Q

What may coal workers pneumoconiosis develop into

A

PMF

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27
Q

Def progressive massive fibrosis (PMF)

A

Presence of large nodules (>10mm) on CXR

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28
Q

Development of PMF

A

Progresses relentlessly –> mixed obstructive + restrictive pattern
–> Respiratory failure

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29
Q

Problem in obstructive lung diseases

A

SOB due to difficult exhaling all air from their lungs
Exhaled air comes out slower than normal
At end of full exhal, abnorm high amount of air = still in lungs

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30
Q

E.g.s of obstructive lung diseases (4)

A

COPD
Asthma
Bronchiectasis
Cystic fibrosis

31
Q

Problem in restrictive lung diseases

A

Cannot fully fill lungs with air
Lungs are restricted from expanding
From conditions causing stiffness in the lungs itself

32
Q

E.g.s of restrictive lung. diseases (5)

A 
ILD - PF
Sarcoidosis 
Obesity
Scoliosis
NM disease
33
Q

Sx of restrictive lung diseases (2)

A

Progressive exertional dyspnoea

Dry cough

34
Q

What is pulmonary fibrosis

A

Umbrella term for different conditions –> build up of scar tissue in the lungs

35
Q

What type of disease is pulmonary fibrosis

A

An interstial lung disease

36
Q

What is an interstitial lung diesase

A

Disease affecting the tissue that lies between the alveoli and pulmonary capillaries

37
Q

Cause of idiopathic PF

A

Unknown

Some links to acid reflux, viruses, breathing in dusts

38
Q

type of HS reaction hypersensitivity pneumonitis

A

III

39
Q

What is hypersensitivity pneumonitis due to

A

Inhaled antigens -> chronic inflammation –> fibrosis

40
Q

3 e.g.s of hypersentivity pneumonitis

A

Farmers lungs
Bird fanciers lungs
Malt workers lungs

41
Q

Cause of farmers lungs

A

Micropolyspora

42
Q

Cause of bird fanciers lungs

A

Proteins in bird droppings

43
Q

Cause of malt workers lungs

A

Aspergillus

44
Q

Drugs causing pulmonary fibrosis (2)

A

Penicillamine

Nitrofurantoin

45
Q

Cause of T1RF

A

Disease of the lung parenchyma

E.g.s asthma, pulm oedema, pneumonia, PE, COPD. ARDS

46
Q

Cause of T2RF

A

When alveolar ventilation is insufficient to excrete the vol of CO2 being prod by tissue metabolism

47
Q

Causes of T2RF (14)

A 
Severe asthma
Severe COPD
Severe PF
PSA
CNS pathology
Sedative Dx 
Rib fracture 
Kyphoscoliosis 
Flail chest
Diaphragmatic paralysis 
MG
GBS
Cord lesions 
Poliomyelitis
48
Q

What is pectus excavatum

A

Anterior chest wall abnormality –> displacement of heart + slight breathlessness

49
Q

Is pectus carinatum signif?

A

No

50
Q

CF of hypoxia (4)

A

Dyspnoea
Agitation
Confusion
Central cyanosis

51
Q

Features of hypercapnia (6)

A 
Headache 
TachyC
Bounding pulse
CO2 retention flap 
Papilloedema 
Features of acidosis
52
Q

Kussmual resp

A

Air hunger –> deep + laboured breathing

53
Q

pH in acute hypercapnic respiratory failure

A

<7.3

54
Q

pH in chronic respiratory failure

A

Just slightly < than normal

55
Q

What is the normal anion gap?

A

11-18mmol/L

56
Q

What does a normal anion gap in metabolic acidosis suggest?

A

Loss of bicarbonate

57
Q

Causes of metabolic acidosis with normal anion gap (4)

A

RTA
Diarrhoea
Drugs (acetazolomide)
Pancreatic/intestinal fl

58
Q

What is a raised anion gap in metabolic acidosis suggest?

A

Production of organic acids

59
Q

Causes of metabolic acidosis / raised anion gap (4)

A

Lactic acidosis
Ketosis
urate (renal failure)
Dx

60
Q

causes of respiratory alkalosis (5)

A 
Anything --> hyperventilation 
Anxiety 
Pain 
Altitude 
Incr met demands - pregnant, sepsis, fever, hypothyroid
Dx (NSAIDS/OD)
61
Q

Causes of metabolic alkalosis

A

XS base - antacids

Loss of acid - vomiting, hypokalaemia, burns, hyperaldosteronism

62
Q

Lobectomy - indications (4)

A

Lung cancer
Bronchiectasis
Chronic lung abscess, TB
Fungal infections

63
Q

Inspection findings - lobectomy

A

Thoracotomy scar

CHx wall flattening on side of surgery

64
Q

Palpation findings - lobectomy

A

Tracheal displacement towards surgical side

Reduced expansion

65
Q

Percussion findings - lobectomy

A

Hyper-resonant on side of lobectomy

66
Q

Ausculation findings - lobectomy

A

Reduced air entry over site

67
Q

What is sarcoidosis

A

Systemic, non-caseating granulomatous disease

68
Q

Who gets sarcoidosis

A

F 20-40

69
Q

PS sarcoidosis

A

Non-specific malaise + arthralgia

70
Q

Other manifestations of sarcoid

A 
Pulmonary fibrosis 
Erythem nodosum 
Glomerulonephritis 
Cardiomyopathy 
Arthritis 
CN lesions
71
Q

Mx sarcoidosis

A

Simple analgesia
NSAIDs
If lung fibrosis - CCS

72
Q

What 5 ways can aspergillus affect the lungs

A 
Asthma (T1HS spores)
EAA - malt workers lung 
Allergic bronchopulmonary asperigillosis 
Aspergilloma 
Invasive aspergillosis
73
Q

Causes of clubbing

A

Intrathoracic neoplasm
Suppurative (pus) lung diseases - Abscess/CF/bronchiectasis/fungal infection
Fibrotic lung disease - IPF/asbestosis/fungal infection
CV disease - congen lesion/infective endocarditis/aortic aneurysm
GI - IBD/Coeliac
Liver - chronic hepatitis/cirrhosis
Thyroid acropachy

CP3 Medicine (29 decks)

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