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Clin Med I - Pulmonary > Sarcoidosis & Pneumoconiosis > Flashcards

Sarcoidosis & Pneumoconiosis Flashcards

1
Q

Define sarcoidosis

A
  • chronic, multisystem, inflammatory, granulomatous disorder
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2
Q

What is the etiology of sarcoidosis

A
  • unknown
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3
Q

How does sarcoidosis manifest?

A
  • noncaseating granulomas in lungs & intrathoracic LN
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4
Q

What presents with caseating granulomas?

A
  • TB
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5
Q

Define pneumoconiosis

A
  • occupational and environmental restrictive lung disease
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6
Q

What is the pathophysiology of sarcoidosis?

A
  • T cells cause an excessive cellular immune reaction
  • leads to central immune system activation
  • excessive T cell collection leads to granuloma formation
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7
Q

What is the identifying hallmark of sarcoidosis?

A
  • non-caseating granulomas
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8
Q

What are the MC organs affected by sarcoidosis?

A
  1. lungs
  2. skin
    also LN & eyes
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9
Q

What pulmonary findings will present with sarcoidosis?

A
  • usually normal
  • crackles
  • exertional O2 desat
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10
Q

What are the dermatological findings with sarcoidosis?

A
  • erythema nodosum
  • LE maculopapular rash
  • lupus pernio (most specific)
  • violacious rash on the cheeks or nose
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11
Q

What are the ocular findings of sarcoidosis?

A
  • uveitis
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12
Q

How is sarcoidosis dx’d?

A
  • CXR
  • CT
  • gallium scan
  • bx
  • PFTs
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13
Q

What is stage 0 sarcoidosis?

A
  • normal CXR
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14
Q

What is stage I sarcoidosis?

A
  • (B) hilar LAD
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15
Q

What is stage II sarcoidosis?

A
  • (B) hilar LAD

- infiltrates

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16
Q

What is stage III sarcoidosis?

A
  • infiltrates only
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17
Q

What is stage IV sarcoidosis?

A
  • fibrosis
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18
Q

What is the MC abnormality on PFTs

A
  • isolated decrease in DLCO
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19
Q

What else must be tested in sarcoidosis?

A
  • CV, not diagnostic
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20
Q

What is the tx of sarcoidosis for pulmonary dz?

A
  • prednisone

- steroids

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21
Q

What is the tx for extrapulmonary sarcoidosis dz?

A
  • steroids
22
Q

What is the tx for ocular sarcoidosis dx?

A
  • steroids
23
Q

When is a lung transplant part of the tx of sarcoid?

A
  • advanced pulmonary fibrosis
24
Q

Define asbestosis

A
  • diffusing pulmonary interstitial fibrosis occurring in asbestos exposed workers/bystanders/community
25
Q

Describe the pathology of asbestosis

A
  • inhalation of asbestos fibers leads to inflam with scarring of alveolar-capillary membrane leading to pulm fibrosis & functional deterioration
26
Q

What is asbestosis directly related to?

A
  • intensity & duration of exposure
27
Q

When does asbestosis manifest?

A
  • 10-20y s/p exposure
28
Q

What are the S&S of asbestosis?

A
  • dyspnea on exertion
  • chest pain
  • productive cough
  • concomitant bronchitis or respiratory infx
  • rales
29
Q

What is seen on CXR in asbestosis?

A
  • pleural plaques
  • pleural effusion
  • irregular, linear opacities in lower lung
30
Q

What is seen on PFT in asbestosis?

A
  • normal FEV1/FVC ratio

- decreased FC, TLC, and DLCO

31
Q

What is seen on bx of asbestosis?

A
  • fibrosis

- fibers/asbestos bodies

32
Q

What is the tx for asbestosis?

A
  • smoking cessation
  • tx early S&S PNA
  • bronchodilator/steroids/O2
  • lung transplant
33
Q

What are potential complications of asbestosis?

A
  • cor pulmonale
  • malignancy
  • PAH
  • R sided heart failure
34
Q

What is the primary prevention of asbestosis?

A
  • follow OSHA guidelines
35
Q

What is the secondary prevention of asbestosis?

A
  • vaccinations
36
Q

Define Coal Worker’s Pneumoconiosis (CWP)

A
  • chronic, usually occupational acquired, restrictive lung disease from respirable coal dust
37
Q

What is the pathophysiology of CWP?

A
  • dust laden macrophages accumulate in the alveoli and trigger immune response
  • coal macules form discrete areas of fibrosis
38
Q

What is seen on PE in CWP?

A
  • asx
  • chronic bronchitis/COPD sx
  • cough, dyspnea, lung function impairment
39
Q

What test should be done for CWP?

A
  • CXR
  • CBC
  • PFTs
40
Q

What is the tx for CWP?

A
  • symptomatic
  • O2 for hypoxemia
  • serial CXR monitoring
  • smoking cessation
  • immunizations
  • transfer jobs
41
Q

What are potential complications from CWP?

A
  • progressive massive fibrosis
  • Caplan Syndrome
  • TB
  • CA
42
Q

Define silicosis

A
  • fibronodular lung dz caused by inhalation of dust containing crystalline dust
43
Q

How does silicosis present?

A
  • dyspnea
  • cough
  • weakness
44
Q

What is the testing for silicosis?

A
  • CXR
  • CT
  • PFTs
  • PPD (mantoux)
45
Q

What is seen on CXR in silicosis?

A
  • (B) alveolar filling
  • ground glass
  • small nodules
  • eggshell calcifications
46
Q

What is the tx for silicosis?

A
  • prevent further exposure
  • quit smoking
  • immunize
  • steroids
  • lung transplant
  • tx active TB & other complications
47
Q

What is the pathophysiology of chronic beryllium dz?

A
  • Tc –> proinflam cytokines –> non-caseating granulomatous inflam
48
Q

What are the S&S of chronic beryllium dz?

A
  • dyspnea
  • cough
  • chest pain
  • arthralgia
  • fatigue
  • wt loss
  • inspiratory crackles
  • LAD
  • rash
  • hepatosplenomegaly
49
Q

How is chronic beryllium dz diagnosed?

A
  • blood/bronchoalveolar lavage (BAL)
  • beryllium lymphocyte proliferation test (BeLPT)
  • CT
  • spirometry
50
Q

What will be seen on CT in chronic beryllium dz?

A
  • ground glass opacification
51
Q

What is the tx for chronic beryllium dz?

A
  • refer
  • symptomatic tx
  • steroids, if they fail methotrexate
  • O2

Clin Med I - Pulmonary (16 decks)

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