Term
| pneumoconiosis (occupational lung diseases) |
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Definition
| inhalation of inorganic particulate matter. silicosis (hard rock miners), coal worker's, asbestos (inhalation and heat treatment), talc, berylliosis (metal alloys) |
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Term
| hypersensitivity pneumonitis (occupational lung diseases) |
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Definition
| inhalation of organic dust |
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Term
| history for occupational lung diseases |
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Definition
| job (chronology of all- titles and tasks), exposure at work, use of preventative mechanisms (respirators..),. other exposures outside of work?, family member brought dust to home? |
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Term
| clinical picture for occupational lung diseases |
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Definition
| signs, symptoms, pulmonary function tests, onset (gradual), |
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Term
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Definition
| very common, 3 forms of free silica (quartz, cristobalite, tridymite), want dosage of silica, intensity, duration, 7x inc rate in african americans, host factors |
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Term
| occupations at risk of silicosis |
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Definition
| agrucultural (plowing, harvesting...), crushing operations (road construction, tunneling...), raw material processing (glass, ceramics, sandblasting!..), automotive repair. Seen a lot in Pennsylvania, coal mining regions, West Coast |
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Term
| pathophysiology of silicosis |
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Definition
| inhaled silica -> acute inflammation -> fibrosis of lungs -> large particles deposit in ciliated airways (middle sized are worst)-> strong macrophage response and they release TNF and ILs -> inflammation, collagen synthesis, fibrosis -> silica dioxide bonds w phospholipids -> destruction of macrophages -> destroyed macrophages release silicone and toxic products and get silica nodule made of pink collagen, more exposure and more nodules -> restrictive lung disease and increased risk of lung carcinoma |
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Term
| related health effects of silicosis |
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Definition
| inc risk of mycobacterium infection, industrial bronchitis and COPD, extrapulmonary disease, lung cancer. slowly progressing, few symptoms early on, latency period of greater than 10 years after exposure, |
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Term
| CT and Xray findings for silicosis |
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Definition
| nodules, subpleural plaques, can have progressive massive fibrosis (mass >2cm), mixed restrictive and obstructive on PFTs but typically restrictive, empysema may be seen, cavitation is possible (look for cancer or mycobacteria) |
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Term
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Definition
| very short latency between 2 and 10 years, typically in patients with high, high, high rate of exposure, get progressive massive fibrosis, higher risk for mortality |
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Term
| how does silicosis affect your immune system |
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Definition
| reduces defenses, alters lymphatic function, destruction and dysfunction of alveolar machrophages (which are impt in fighting off tb) |
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Term
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Definition
| inc symptoms of chronic bronchitis, can develop emphysema, potentiates the effects of smoking- destruction of alveoli, accelerated rates of FEV1 decline |
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Term
| extrapulmonary disease and silica |
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Definition
| can spread to lymph nodes, liver, spleen, kidneys, can get scleroderma, rheumatoid arthritis, other CT diseases |
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Term
| silica group __ substance |
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Definition
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Term
| medical management of silicosis |
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Definition
| smoking cessation, oxygen, vaccination, screen for TB and bacterial infections |
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Term
| coal worker's pneumocosis |
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Definition
| deposits of coal and silica in the lungs, highly inflammatory, long-term exposure |
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Term
| risk factors for coal worker's pneumocosis |
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Definition
| duration of exposure, intensity, prevalence of the disease |
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Term
| pathophysiology of simple coal worker's pneumocosis |
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Definition
| accumulation of carbon dust in lungs -> enters terminal bronchioles and engulfed by alveolar macrophage which surround the bronchioles and tissues in the lungs -> dilation of respiratory units -> dysfunction of smooth muscle, alterations in structural components -> signs/symptoms |
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Term
| pathophysiology of complicated coal worker's pneumocosis |
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Definition
| the dust removal process fails. we normally have ciliated cells in our upper airways and lungs to flush out these particles but they get paralyzed -> macrophages accumulate -> inflammatory reaction -> fibroblasts activated, lay down collagen -> snares the macrophages there which lyse and release carbon, silica, cause more inflammation. inflammatory lesions coalesce and get massive pulmonary fibrosis |
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Term
| potential complications of coal miner's pneumocosis |
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Definition
| mycobacterial infection, diffuse pulmonary interstitial fibrosis, rapidly progressive coal worker's pneumonitis, cavitations, fungal infections in the cavitary lesions, and hilar node involvement (can affect recurrent laryngeal nerve- hoarseness) |
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Term
| total respiratory disability |
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Definition
| clinical findings of progressive massive fibrosis, FEV1 less than 60% of predicted, abnormal ABGs, reasoned medical opinion |
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Term
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Definition
| minerals that when crushed produce fibers, causes diffuse interstitial fibrosis, exposed removing from old buildings or asbestos mining or talc contaminated w it |
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Term
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Definition
| fibers inhaled -> deposit in wall of distal airways and alveoli -> ingested partially by macrophages, may penetrate the interstitial spaces -> develop asbestos bodies, coated fibers -> inflammation w activated macrophages -> inc growth factors -> production of fibroblasts -> fibrosis -> airway obstruction and interstitial fibrosis |
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Term
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Definition
| mesothelioma (cancer of the lining of the pleural space, even w lower exposures) , also benign diffusions, pleural plaques |
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Term
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Definition
| dyspnea on exertion, dry mouth, crackles in lungs, clubbing, scarring begins around the bronchioles, 10% do not have pleural plaques (usually bilateral), small volume pleural effusions that may be hemorrhagic or eosinophilic |
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Term
| tests and findings of asbestosis |
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Definition
| restrictive pattern on PFT w dec diffusion capacity |
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Term
| benign asbestosis pleural plaques |
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Definition
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Term
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Definition
| asbestos-related cancer, fiber diameter <2.2mm or length >8mm is high risk, 30-50 year latency |
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Term
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Definition
| treat COPD, emphysema, chronic bronchitis, smoking cessation, supplementary oxygen, pulmonary rehab, bronchodilators, antibiotics |
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Term
| hypersensitivity pneumonitis |
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Definition
| granulomanous lung disease resulting from repeated inhalation and sensitization to organic aerosols and low molecular weight antigens. an immune-complex mediated disorder, delayed hypersensitivity reaction, only occurs in susceptible individuals, have to have exposure, symptoms highly variable in duration and intensity, signs and symptoms due to repeated exposures |
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Term
| symptoms of hypersensitivity pneumonitis |
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Definition
| fevers, chills, SOB, within 4-12 hrs of exposure, can be associated by work, hobbies, symptoms may improve w change of environment |
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Term
| pathophy of hypersensitivity pneumonitis |
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Definition
| inc neutrophils in terminal bronchioles and alveoli, then become mononuclear cells -> migrate to affected areas -> delayed hypersensitivity rxn, interleukins, interferon, TNF -> upregulation of TNF and reduction of lymphocyte death -> triggers underlying delayed hypersensitivity rxn, can be acute or chronic, hypersensitivity rxn type III or IV |
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Term
| etiologies of hypersensitivity penumonitis |
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Definition
| just about anything, bacteria, fungi, aspergillus, penicillin, animal proteins, bird proteins, fishmeal, rat urine |
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Term
| classic hypersensitivity pneumonitis |
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Definition
| farmer's lung- bacilli or actinomycetes from grains and silage, bird pancier's lung in ppl who deal w pigeons adn birds, avian proteins, moldy environments, contaminated AC, hottubs, mushroom workers, construction or industrial workers |
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Term
| diagnosis of hypersensitivity pneumonitis |
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Definition
| exposure to a known sensitizer, abnormal spirometry, restrictive, obstructive or mixed, presence of specific IgG Ab's to the substance/protein, abnormal imaging, lymphocytosis on bronchioalveolar fluid eval |
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Term
| treatment of hypersensitivity pneumonitis |
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Definition
| minimize contact, clean source, protective equipment, glucocorticoids for acute exacerbation |
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