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Session 2 CM pulm11

CM- pulm -11- Occupational Disease

If you have increased compliance but decreased elasticity what type of lung disease do you have obstructive lung disease. Take long to force air out of the lungs
What will you see in residual volume in obstructive disease you will have an increase in residual volume
What do you see in FEV1 and FVC, and FEV1/FVC in obstructive lung disease FEV1 will be decreased FVC will be decreased FEV!/FVC will be less than normal (42%)
What are some common obstructive lung diseases COPD, Emphysema, Chronic bronchitis, Asthma, and Bronchiectasis
lung disease where you have decreased TLC, (decreased lung compliance), Increased lung elasticity and decreased residual volume Restrictive lung disease
Diffuse, chronic involvement of pulmonary interstitial tissue and fibrosis restrictive lung disease
What will you see in restricive airway disease in FEV!, FVC, FEV!/FVC FEV1 will be lower FVC will be lower FEV!/FVC will he increased to about 90%
What are the clinical s/sx of restrictive lung disease dyspnea tachypnea cyanosis hypoxemia chest x-ray- diffuse infiltration "ground Glass"
What are common restricitve lung diseases pneumoconiosis, hypersensitivity pneumonitis, sarcoidosis, idiopathic pulmonary fibrosis
What is pneumoconiosis occupational disease where inhalation of materials predisposes lungs to damage.
How does pneumoconiosis develop inhaled particles agravate lung and cause alveolar macrophages to migrate and start to secrete mediators that injure parenchymal cells stimulates interstitial edema, and infalmmation response leading to interstitial fibrosis
What is disease coal worker is likely to present with coal workers pneumoconiosis "BLACK lung disease"
Where are you most likely going to see the nodules associated with coal workers pneumoconiosis in the upper lobes progresses to massive fibrosis and blackened scars
what is anthracosis 1-2 mm nodules seen in coal workers pneumoconiosis which are carbon-laden macrophages. Lesions are scattered throughout the lung but especially in upper lobes
what is it called when a patient has coal workers pneumoconiosis and rheumatoid arthritis Caplan's Syndrome
What is the tx for pneumoconiosis relieve respiratory symptoms, manage hypoxia and cor pulmonale. Avoid respiratory tract irritants and infections Monitor carefully for TB
What can you order to help respiratory symtpoms of patient with pneumoconiosis bronchodilator therapy with theophylline or aminophylline Oral or inhaled sympathomimetics, corticosteroids or cromolyn sodium aerosol
What is the most prevalent occupational disease world wide pneumoconiosis
what is the pneumoconiosis called when it is from inhalation of crystalline silicon dioxide. silicosis
is there an association with silicosis and developing lung cancer no
How does silicosis typically present presents as a slow progressing nodular fibrosing pneumoconiosis of the UPPER LUNGS
where is silicosis common sandblasting, crushing stones, quartz and iron-containing ore mining
Pneumoconiosis from inhaling asbestos fibers asbestosis
Who is most likely to develop asbestosis people working on brake linings, cement pipes and insulation materials (especially from awhile ago)
what are the 2 types of asbestos serpentine-curly felixble fibers amphiboles- straight stiff, brittle fibers that can be delivered into the lungs
What are the s/sx of asbestosis dyspnea with productive cough. Generally appears >10yrs later Chest x-rays reveal irregular linear densities in both lower lobes and mid thoracic pleural plaque formation Pleural Plaques
What are asbestos bodies golden brown beaded rods with a translucent center. macrophages attempt to phagocytize asbestos fibers and coat the fibers with iron protein complexes
if a person has exposure to asbestos and is a smoker what are they more likely to develop lung cancer or mesothelioma bronchogenic carcinoma lung cancer
if a person has exposure to asbestos and is a NON-smoker what are they more likely to develop lung cancer or mesothelioma mesothelioma
if your patient works in the nuclear or aerospace industry they have the highest exposure and risk of developing what type of occupational lung disease berylliosis
If a person has prolonged exposure to metallic beryllium fumes what are they at risk for developing non-caseating granulomatous lesions and hilar adenopathy similar to sarcoidosis also lung cancer
immune mediated, interstitial lung disease caused by exposure to inhaled antigens hypersensitivity pneumonitis
why do you need to recognize hypersensitivity pneumonitis early on you can't prevent development of serious chronic fibrosis by removing exposure to the environmental agent
what are the most common causes of hypersensitivity pneomonitis inhaling spores, fungi, animal proteins, or bacterial products
How long after exposure does a person typically develop symptoms of hypersensitivity pneumonitis 4-6 hours
What are some common hypersensitivity pneumonitis conditions farmer's lung silo filler's disease bird fancier's disease
What is the hypersensitivity generally developed in textile industry byssinosis "brown lung disease"- from exposure to endotoxins from gram negative bacteria that grow on the cotton fiber the worker inhales
what is the deadly hypersensitivity pneumonitis that develops after inhaling water droplets containing bacteria. Generally grows in Air Conditioners Legionnaire's disease
what is the tx for legionnaire's disease erythromycin
what test would you order to determine if your patient is likely suffering from obstructive or restrictive spirometry
What is TV in spirometry Tidal Volume- the amount of air that moves into and out of the lungs during quiet, relaxed breathing. In the average person this is about 500 ml.
What is IRV inspiratory reserve volume- amount of air that can be inspired forcibly beyond the tidal volume normally 2100-3200ml
What is ERV expiratory reserve volume- amount of air that can be forcefully evacuated from the lung after tidal expiration. normally 1000-1200
What is RV residual volume- help keeps lungs from collapsing. amount of air left after forced exhalation. normally 1200ml
What is TLC Total lung capacity- sum of all lung volumes usually 6000ml
what is VC vital capacity- total amout of exchangeable air usually 4800ml
what is IC inspiratory capacity- total amount of air that can be inspired after tidal expiration usually 3600ml
What is FRC functional residual capacity- volume of air that remains trapped in the lungs after a normal tidal volume expiration
What is FEV1 forced expiratory volume 1- volume of air forcefully exhaled in one second
what is FVC forced vital capacity- volume of air that can be maximally forcefully exhaled
what is FEV1/FVC ratio of air expelled in 1 second to total air expelled
what is PEFT peak flow rate during expiration
what is the normal FEV1/FVC ratio 80%
what will you see in FEV1/FVC ratio in obstructive disease ratio will decrease to 40% because FEV1 is decreased
what will you see in FEV1/FVC ratio in restrictive disease FEV1/FVC will be increased to about 90% because patient can't inspire as much.
Created by: smaxsmith