Respiratory

Question 0

Caplan’s syndrome (rheumatoid pneumoconiosis) is associated with ?

Answer 0

Coal worker’s pneumoconiosis

Question 1

Hypersensitivity pneumonitis ( Allergic alveolitis) is caused by exposure to?

Answer 1

Organic dust, esp. Thermophilic bacteria

Most common - “ Farmer’s lung”

Question 2

Metal fume fever is due to?

Answer 2

Exposure to oxides of heavy metals, esp. Zinc

Question 3

The most reliable diagnostic tool for monitoring respiratory function in workers exposed to respiratory hazards?

Answer 3

Spirometry (FEV1, FVC)

Question 4

Cotton dust endotoxin exposure causes what disease?

Answer 4

Byssinosis

Question 5

Spirometric testing

Answer 5

Volume recording:
FVC
- Forced Vital Capacity
- Total volume of air expelled in spirometer if maneuver
FEV-1
- Forced Expiratory Volume in 1- second
- FEV-1 = volume of air expelled in the first second of expiration

Question 6

FEV-1/FVC ratio:

Answer 6

FEV-1/FVC ratio

= volume expelled in the first second to the total volume

Question 7

Spirometric indices

Answer 7

1. Normal FEV-1 & FVC
   usually both = or > 80% of predicted value
2. Normal FEV-1/FVC ratio
   = or > 70% of predicted

Question 8

Spirometer indices in Obstructive lung diseases

Answer 8

1. FVC: normal
2. FEV-1: Low (<70%)
3. FEV-1/FVC: Low

Question 9

Spirometric indices in Restrictive lung disease

Answer 9

1. FVC: Low (70%)
2. FEV-1: Low(70%)
3. FEV-1/FVC: normal

Question 10

Pneumoconiosis

Answer 10

Silicosis
Asbestosis
Coal worker’s pneumoconiosis
Other

Question 11

Pneumoconiosis

Answer 11

Dusty lungs after 10-20 years exposure of dust (silica, coal, or asbestos), caused permanent parenchymal fibrotic change

Question 12

Silicosis is Sensitive to

Answer 12

TB
Anaerobic infection

(Silicosis deposited in the upper lung, decreased the O2 in the upper lung)

Question 13

X-ray of silicosis

Answer 13

1. Upper lung pathology - small round opaque change

2. “Egg shell” nodule -Hila infiltration

Question 14

Inhalation injury

Answer 14

Irritant gases and fumes

Solubility determines upper or lower airway symptoms

Question 15

Inhalation injury

- Ammonia, sulfur dioxide

Answer 15

High water solubility

Upper airway deposit

Question 16

Inhalation injury

- chloride

Answer 16

moderate water solubility

Lower airway

Question 17

Inhalation injury

- phosgene, nitrogen oxide

Answer 17

low water solubility

Terminal airway

Question 18

Hypersensitivity pneumonitis

Answer 18

Eg. Farmer's lung
      Bagassosis
      Humidifier lung
      Pigeon breeder's lung
      Maple bark-stripper's lung

Question 19

RADS - Reactive Airway Dysfunction Syndrome

Answer 19

An irritant asthma
Due to irritating agent, not an immunologic sensitizer
Usually with high or massive exposure to irritating agent

Question 20

Calcification of the diaphragm

Answer 20

Is so rare that it’s finding is almost pathognomic for asbestosis

Question 21

Inhalation of anthracite (hard coal) dust is more dangerous than inhalation of bituminous (soft coal) dust

Answer 21

Because

1. The smaller particle size causes more extensive scar formation
2. Anthracite deposits are associated with higher-level of silica dust.

Question 22

Coal worker pneumoconiosis, or “black lung” develops

Answer 22

• In 12% of all miners

- And up to 50% of anthracite miners with more than 20 years of duty exposure

Question 23

Which of the following occupational causes of interstitial lung disease is associated with higher risk of tuberculosis? 
   A. Coal workers pneumoconiosis 
   B. Berylliosis
   C. Silicosis
   D. Asbestos 
   E. Byssinosis

Answer 23

C. Silicosis