Week 7: Obstructive and Restrictive Lung diseases Flashcards
Occupation asthma often occurs at what period
Within 1 year of starting new work
Pattern of symptoms in occupational asthma
- Worsening during the week
* Improvements at weekends
Risk factors for occupational asthma
- inherent atopy
- smoking
- rhinitis and conjunctivitis (precede development of OA)
Main types of asthma
- Allergic asthma (associated with atopy)
- Occupational asthma (non-allergic)
- Other non-allergic asthma: viral, cold, stress
Difference between sensitiser induced and irritant induced occupational asthma.
Which is more common
More common: sensitiser induced
SENSITISER
Latency period between exposure and symptoms
IRRITANT
Symptoms occur a few hours after high concentration exposure to irritant
Who is responsible for reporting injuries, diseases and dangerous occurences during work
The employer
What does PD20 mean
Provocative dose causing 20% drop in FEV1
significance of FeNO
Measures bronchial activity (but non-specific)
significance of sputum eosinophils
Correlates with challenge test
but levels will be lower if smoking
What class of drug would improve symptoms and prognosis in COPD patients
LAMA
What PaO2 levels signify that a COPD patient needs long term oxygen therapy
PaO2<7.3
OR
PaO2<8 +
- polycythaemia
- pulmonary hypertension
- peripheral oedema
- noctural hypoxaemia
What type of air content should be given in a nebuliser for a COPD pt
- low oxygen
- high CO2
5 drugs for symptomatic treatment of pulmonary hypertension
- Warfarin
- Oxygen
- Diuretics
- Digoxin
- CCB
4 drugs for pulmonary hypertension to improve prognosis
- Endothelin receptor antagonists (eg bosentan)
- Phosphodiesterase 5 inhibitors (eg tadalafil)
- Prostaglandins (eg epoprostenol)
- Soluble guanylate cyclase stimulators (eg riociguat)
5 Lung diseases that exposure to silica can cause
- Silicosis (lung fibrosis)
- Acute silicosis
- COPD
- TB
- Lung cancer
How would sarcoidosis present on a CXR
Bilateral hilar lymphadenopathy
+/- pulmonary infiltrates
How would sarcoidosis present on a lung biopsy
Dense fibrosis with birefringent particles
How would coal workers pneumoconiosis present on a lung biopsy
Dust accumulation around terminal bronchioles + fibrosis
What respiratory condition might experiencing cold-like symptoms after work suggest
Hypersensitivity pneumonitis/ Alveolitis
How would IPF appear on cxr
- fibrotic white patches at base of lung
- big bronchi (pulled apart by scarring)
- Honeycomb (subpleural fibrosis)
IPF/ bronchiectasis gives fine/ coarse inspiratory crackles
IPF = fine inspiratory crackles (like velcro)
Bronchiectasis (obstructive) = coarse crackles
How would sarcoidosis appear on histology
Non-caseating granulomas
Squeaks on auscultation indicate
Hypersensitivity pneumonitis
