toxic exposures

Question 1

silicosis

Answer 1

fibrotic lung disease caused by inhalation of crystalline silica, ususally quartz
sandblasting
jeans manufacturing
stone work

Question 2

chronic silicosis

Answer 2

most common form
20+ years after exposure
silicotic nodule characterized by whorled hyalinized collagen fibers with a more peripheral zone of dust laden macrophages

Question 3

accelerated silicosis

Answer 3

nodules 2-3 years post exposure

clinical course progressive

Question 4

acute silicosis

Answer 4

aka silicoproteinosis
6months-2 yrs post exposrue
rapidly progress to respiratory failure and death
alveolar filling process

Question 5

progressive massive fibrosis sarcoidosis

Answer 5

lesions are at least 1cm in diameter, often larger
usually involve upper lobes
respirartory failure

Question 6

sarcoidosis increases risk for what diseases

Answer 6

TB
COPD
chronic bronchitis
RA and sclerederma
lung cancer

Question 7

sarcoidosis CXR

Answer 7

symmetric nodular pattern involving upper lobes
hilar adenopathy w/eggshell calcification
acute- air space and interstitial pattern

Question 8

sarcoidosis PFT

Answer 8

normal in early disease

combo of obstructive and restrictive in late

Question 9

coal worker pneumoconiosis

Answer 9

anthracite most toxic

Question 10

pathology of coal worker pneumoconiosis

Answer 10

coal macule consisting of macrophages laden w/coal dust w/in the walls of respiratory chronchioles and adjacent alveoli
coal nodules
progressive massive fibrosis may be seen

Question 11

coal worker pneumoconiosis at risk for what other diseases

Answer 11

silicosis
scleroderma
caplan syndrome
NO increased chance of TB or cancer

Question 12

coal worker pneumoconiosis PFT

Answer 12

normal in early
often obstructive later
can be restrictive w/fibrosis
causes emphysema

Question 13

coal worker pneumoconiosis CXR

Answer 13

resembles silicosis
small rounded opacities in liung parnechyma
can progress to PMF w/nodules .5 to 5cm

Question 14

asbestosis

Answer 14

chronic fibrotic interstitial lung disease
20yrs after exposure
clubbing commonly seen

Question 15

asbestosis exposures

Answer 15

brake lineing
shipbuilding
insulations
fireprogging
mining
milling
construction

Question 16

asbestosis pathology

Answer 16

ferruginous bodies

asbestos bodies in sputum or BAL fluid

Question 17

asbestosis at risk for what other conditions

Answer 17

mesothlioma
lung cancer
pleural effusions

Question 18

asbestosis CXR

Answer 18

pleural thickening and rounded atelectasis a/comet tail

subpleural diseases are prominent

Question 19

asbestosis PFT

Answer 19

restrictive, but obstructive can be seen

Question 20

asbestosis Diagnosis

Answer 20

eposure and CXR essential

Question 21

beryllium disease inductries

Answer 21

aerospace
electronics
ceramics
metal 
nuclear
telecommunications
tool and die
welding

Question 22

beryllium acute toxic pneumonitis

Answer 22

high exposure hypersensativity rxn

rare

Question 23

chronic beryllium disease

Answer 23

similar to sarcoidosis, ranging from asymptomatic - severe granulomatous restrictive disease
arthralgias
20 years after sxposure

Question 24

beryllium CXR

Answer 24

enlarged hilar or medistinal lymph nodes

later stages- patchy fibrosis, hyperinflation, honeycombing

Question 25

beryllium diagnossi

Answer 25

BeLPT