Page 721 - First Aid for the USMLE Step 1 2020, Thirtieth edition [MedicalBooksVN.com]_Neat
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RespiRatoRy ` RESPIRATORY—PAThOlOgY RespiRatoRy ` RESPIRATORY—PAThOlOgY seCtioN iii 677
Pneumoconioses Asbestos is from the roof (was common in insulation), but affects the base (lower lobes).
Silica and coal are from the base (earth), but affect the roof (upper lobes).
Asbestosis Associated with shipbuilding, roofing, Affects lower lobes.
plumbing. “Ivory white,” calcified, Asbestos (ferruginous) bodies are golden-brown
supradiaphragmatic A and pleural B plaques fusiform rods resembling dumbbells C ,
are pathognomonic of asbestosis. found in alveolar sputum sample, visualized
Risk of bronchogenic carcinoma > risk of using Prussian blue stain, often obtained by
mesothelioma. risk of Caplan syndrome bronchoalveolar lavage.
(rheumatoid arthritis and pneumoconioses risk of pleural effusions.
with intrapulmonary nodules).
Berylliosis Associated with exposure to beryllium in Affects upper lobes.
aerospace and manufacturing industries.
Granulomatous (noncaseating) D on histology
and therefore occasionally responsive to
steroids. risk of cancer and cor pulmonale.
Coal workers’ Prolonged coal dust exposure macrophages Affects upper lobes.
pneumoconiosis laden with carbon inflammation and Small, rounded nodular opacities seen on
fibrosis. imaging.
Also known as black lung disease. risk of Anthracosis—asymptomatic condition found in
Caplan syndrome. many urban dwellers exposed to sooty air.
Silicosis Associated with sandblasting, foundries, Affects upper lobes.
mines. Macrophages respond to silica “Eggshell” calcification of hilar lymph nodes on
and release fibrogenic factors, leading to CXR.
fibrosis. It is thought that silica may disrupt The silly egg sandwich I found is mine!
phagolysosomes and impair macrophages,
increasing susceptibility to TB. risk of
cancer, cor pulmonale, and Caplan syndrome.
A B C D
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