Term
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Definition
| Lung disease caused by inhalation of inorganic dusts |
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Term
| What are potential complications caused by Pneumoconioses? |
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Definition
| Infections, hypoxemia, strangulation of arterioles and necrosis, air trapping/emphysema, lung carcinoma |
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Term
| What are the 4 major causes of Pneumoconioses? |
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Definition
| Silicon, asbestos (more frequent and severe), coal dust, beryllium |
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Term
| What are the characteristics of Pneumoconioses Silicosis? |
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Definition
| Most common Pneumoconioses in the world, caused by crystalline silicon dixonxide, occurs in mining, blasting, etc., causes an intense fibrotic reaction and increases risk of mycobacterial infections (TB) |
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Term
| What are the symptoms associated with Pneumoconioses Silicosis? |
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Definition
| Shortness of breath while exercising, occasional bluish skin at earlobes/lips, fatigue |
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Term
| What would you see in a chest x-ray that indicates acute silicosis (developing >5years) |
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Definition
| Widespread consolidations and nodular opacities on chest x-ray |
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Term
| How is Pneumoconioses Silicosis diagnosed? |
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Definition
| History and characteristic X-ray findings (nodular opacities and widespread consolidation) |
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Term
| How is Pneumoconioses Silicosis treated? |
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Definition
| Mainly supportive, oxygen rehab, patient should have yearly TB test |
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Term
| What is the prognosis for Pneumoconioses Silicosis? |
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Definition
| Acute and accelerated have poor prognosis, acute can be fatal, PMF has a more varied course and may lead to progressive impairment and respiratory failure |
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Term
| What are the characteristics of Pneumoconioses Asbestosis |
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Definition
| Fibrosis of lung parenchyma due to asbestos exposure, seen in plumbers, shipyards, textiles, insulation, etc. accurate work history is key to diagnosis |
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Term
| What are the symptoms of Pneumoconioses Asbestosis? |
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Definition
| Similar to chronic bronchitis, progressive exertional dyspnea, cough, increased sputum, rales |
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Term
| What may profoundly increase the chance of Pneumoconiosis Asbestosis? |
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Definition
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Term
| What is the natural progression of Pneumoconiosis Asbestosis? |
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Definition
| Disability and lung cancer (mesothelioma) |
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Term
| How does pneumoconiosis Asbestosis manifest? |
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Definition
| Pumonary fibrosis, lung cancer, mesothelioma of the pleura and peritoneum, laryngeal CA, CA of the GI, very slow manifestation (20-40 yrs) |
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Term
| How is Pneumoconiosis Asbestosis diagnosed? |
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Definition
| History of significant exposure, CXR showing pleural plaques and linear opacities, histologic exam reveals “asbestos” (sometimes called “ferruginous”) bodies |
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Term
| How is Pneumoconiosis Asbestosis treated? |
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Definition
| No effective treatment, supportive care, stop exposures, vaccinations, lung transplant in select cases |
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Term
| How do you determine the prognosis for Pneumoconiosis Asbestosis? |
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Definition
| The extent of radiographic fibrosis is a strong predictor of mortality |
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Term
| What are the characteristics of Coal Worker's Pneumoconiosis? |
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Definition
| AKA "black lung", coal macules in the alveoli are histological hallmark, often manifest asymptomatically or similar to bronchitis, progressive dyspnea, pulmonary HTN, respiratory failure |
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Term
| How do you diagnose Coal Worker's Pneumoconiosis? |
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Definition
| History is key, CXR shows nodular opacities |
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Term
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Definition
| Inhalation of a rare metal now widely used in high tech applications, a genetic link to the disease may exist |
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Term
| What is acute Berylliosis? |
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Definition
| Causes an intense inflammatory reaction which resembles chemical pneumonitis |
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Term
| What is chronic Berylliosis? |
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Definition
| A granulomatous disease, primarily affecting the lung |
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Term
| How is Berylliosis diagnosed? |
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Definition
| History of exposure, histologic confirmation, lab confirms through lympmhocyte transformation test |
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Term
| How is Berylliosis treated? |
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Definition
| Steroids are beneficial but must continue for life, supportive care |
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Term
| What are the characteristics of thermal injuries/smoke inhalation? |
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Definition
| Injuries usually confined to upper airways, laryngeal edema may cause airway obstruction, anoxia, may die of pneumonia or organ failure, significant lung damage can occur without external burns, cyanide poisoning risk |
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Term
| What are the 4 types of complications of thermal injuries? |
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Definition
| Immediate reaction-direct injury, CO and cyanide poisoning, Acute Respiratory Distress Syndrome (ARDS) 24-48 hrs after injury, late-onset pulmonary complications |
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Term
| What are some signs and symptoms of thermal injury/smoke inhalation? |
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Definition
| Tachypnea, cough, dyspnea, wheezing, cyanosis, hoarseness, stridor |
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Term
| What occurs phyiologically after smoke inhalation? |
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Definition
| Hypoxemia may progressively worsen, pulmonary edema, CXR may reveal diffuse, patchy infiltrates, infection due to compromised immune system, possible upper airway obstruction |
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Term
| How is smoke inhalation treated? |
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Definition
| Observation for complications, 100% oxygen, |
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Term
| What is carbon monoxide poisoning? |
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Definition
| Tissue hypoxia by competitively displacing oxygen from hemoglobin (affinity of CO for the hemoglobin oxygen-binding sites is 250 times greater than that of oxygen) |
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Term
| What is the leading cause of accidental poisoning in the US? |
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Definition
| CO poisoning due to fires, faulty furnaces, automobile exhaust |
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Term
| What are the clinical features of CO poisoning? |
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Definition
| Often neurologic, headache, confusion, visual changes, nausea, vomiting, classic symptom is cherry red lips and nail beds. Severe cases can produce seizures, transient unconsciousness, coma, and death |
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Term
| How is CO poisoning diagnosed? |
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Definition
| History and COHb levels on ABG |
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Term
| How is CO poisoning treated? |
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Definition
| 100% oxygen, hyperbaric therapy in severe cases |
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Term
| What causes high altitude injury? |
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Definition
| Physiologic changes appearing at altitudes above 8000 ft, affected by: rate of ascent, final altitude, sleeping altitude, duration of stay and individual fitness |
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Term
| What is the most common form of high altitude injury? |
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Definition
| Acute mountain sickness, symptoms include hyperventilation, malaise, anorexia, disturbed sleep |
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Term
| What are the symptoms of high altitude injury? |
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Definition
| Hyperventilation, impaired memory/judgement, headache, malaise, anorexia |
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Term
| Altitudes > 9500 feet may lead to what? |
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Definition
| High altitude cerebral edema (HACE) (uncommon, severe central nervous dysfunction) and High altitude pulmonary edema (HAPE)(potentially fatal) |
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Term
| How is high altitude injury treated? |
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Definition
| Descend when symptoms appear, oxygen, increased fluids |
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Term
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Definition
| Small volume aspiration due to laryngeal spasm |
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Term
| What are signs/symptoms of drowning? |
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Definition
| Hypoxemia, metabolic acidosis, Saltwater vs. Freshwater-minor distinction. Primary effects are dilution of surfactant and hypoxic organ injury, Cardiac arrhythmias. Hypoxic encephalopathies, Renal Insufficiency |
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Term
| What groups have the best prognosis for drowning? |
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Definition
| Hypothermic children have best neurologic prognosis, Survival occurs even after prolonged resuscitive efforts, not dead until warm and dead |
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