Pulmonary Talcosis

Pulmonary Talcosis Clinical Features:

• May initially have non-specific respiratory symptoms.
• Examination may show finger clubbing & respiratory crackles.
• Condition may progress even after exposure has halted.
• More severe symptoms with disease progression include dyspnoea, hypoxaemia & eventually pulmonary hypertension with cor pulmonale.

Talcosis Radiological Features:

• May be pleural plaques similar to asbestos plaques.
• The plaques will often involve the diaphragm, & also occasionally the pericardium.
• Interstitial disease pattern - reticular or nodular, which may appear like asbestosis.
• May develop confluent masses.

Talcosis Aetiological Factors:

• Exposure may be either inhalational or intravenous.
• Industrial settings - mining, milling, rubber industry.
• High exposure from personal talcum powder use.
• Heroin use - where talc is used as an adulterant.

Talcosis Pathophysiology:

• Talc is hydrated magnesium silicate.
• Related to silicosis in view of silicate composition.
• Talc may cause disease in association with other minerals, as there is often contamination with silica, or asbestos.

Image Details: Granulomatous inflammation of the lung secondary to a foreign body reaction in heroin intravenous drug use (IVDU), foreign material demonstrated as talc, H&E stain. By Nephron on Wikipedia (cc)

Tags: Asbestos - Heroin - IVDU - Magnesium Silicate - Milling - Mining - Silica - Silicosis - Talcosis - Inhalational Talcosis - Talcosis
Posted by Medicalchemy
Medicalchemy Group: History of Medicine - Images - Mnemonics - Syndromes - Acute Medicine - Anaesthesiology - Anatomy - Anthropology - Biochemistry - Cardiology - Dentistry - Dermatology - Drug ADR - Drugs - Embryology - Emergency Medicine - Endocrinology - Epidemiology - Family Medicine - Forensic Medicine - Gastroenterology - Genes - Genetics - Geriatrics - Gynecology - Haematology - Health Informatics - Hepatology - Immunology - Infection - Intensive Care - Medical Dictionary - Medical Education - Medical Statistics - Metabolic Medicine - Microbiology - Nephrology - Neuroanatomy - Neuroscience - Nuclear Medicine - Nutrition - Obstetrics - Occupational Health - Oncology - Ophthalmology - Orthopaedics - Otolaryngology - Paediatrics - Palliative Care - Parasitology - Pathology - Pharmacology - Physiology - Proteomics - Psychiatry - Public Health - Radiology - Respiratory - Rehabilitation - Rheumatology - Sports Medicine - Surgery - Toxicology - Tropical Medicine - Urology - Vascular - Virology.

Reactive Airways Dysfunction Syndrome (RADS)

Reactive Airways Dysfunction Syndrome (RADS):

• Persistence of hyper-reactive airways following acute exposure to a respiratory irritant.
• Typically follows a work-related spill or accident.
• The exposure is usually single & intense.
• Can be thought of as an irritant induced asthma.

RADS Clinical Features:

• Symptoms of airways disease - dyspnoea, wheeze, cough.
• Occurring in patient with no previous history of respiratory disease.
• Symptoms beginning within 24 hours of exposure .
• No latent period of prior 'sensitization'.
• Re-exposure to a low dose of the irritant will typically not trigger asthma.
• In work-related cases, the patient may continue to work in the same building once measures have put in place to avoid exposure.
• Bronchial hyper-reactivity can demonstrated, ie methacholine challenge test.
• Pulmonary function tests may be normal or obstructive.
• The features noted may persist for months to years.

Irritant Agents (Examples):

• Acids
• Ammonia
• Chlorine
• Cleaning agents
• Smoke

Tags: Acids - Ammonia - Asthma - Chlorine - Cleaning Agents - Methacholine Challenge Test - RADS - Reactive Airways Dysfunction Syndrome - Smoke
Posted by Medicalchemy
Medicalchemy Group: History of Medicine - Images - Mnemonics - Syndromes - Acute Medicine - Anaesthesiology - Anatomy - Anthropology - Biochemistry - Cardiology - Dentistry - Dermatology - Drug ADR - Drugs - Embryology - Emergency Medicine - Endocrinology - Epidemiology - Family Medicine - Forensic Medicine - Gastroenterology - Genes - Genetics - Geriatrics - Gynecology - Haematology - Health Informatics - Hepatology - Immunology - Infection - Intensive Care - Medical Dictionary - Medical Education - Medical Statistics - Metabolic Medicine - Microbiology - Nephrology - Neuroanatomy - Neuroscience - Nuclear Medicine - Nutrition - Obstetrics - Occupational Health - Oncology - Ophthalmology - Orthopaedics - Otolaryngology - Paediatrics - Palliative Care - Parasitology - Pathology - Pharmacology - Physiology - Proteomics - Psychiatry - Public Health - Radiology - Respiratory - Rehabilitation - Rheumatology - Sports Medicine - Surgery - Toxicology - Tropical Medicine - Urology - Vascular - Virology.

Drug-Induced Pulmonary Eosinophilia

Drug-Induced Pulmonary Eosinophilia:

• Drug associated transient pulmonary infiltrates, with an elevated eosinophil count.
• Clinical spectrum is variable.

Clinical Spectrum:

• Acute picture - simulating hypersensitivity pneumonitis - ie cocaine.
• Insidious onset picture - chronic symptoms & dyspnoea - ie nitrofurantoin.
• Loeffler-like picture - ie penicillin.
• Eosinophilic vasculitis picture - ie zafirlukast.

Drug Causes (Antibiotics):

• Ampicillin
• Minocycline
• Nitrofurantoin
• Penicillin
• Pentamidine (aerosolized)
• Sulfonamide

Drugs Causes (Other):

• Chlorpropamide
• Crack Cocaine
• L-tryptophan
• NSAIDs
• Paracetamol (Acetaminophen)
• Ranitidine
• Zafirlukast

Tags: Antibiotics - Cocaine - Drug-Induced Pulmonary Eosinophilia - Eosinophilic vasculitis - Nitrofurantoin - Pneumonitis - Pulmonary Eosinophilia - Pulmonary Infiltrate
Posted by Medicalchemy
Medicalchemy Group: History of Medicine - Images - Mnemonics - Syndromes - Acute Medicine - Anaesthesiology - Anatomy - Anthropology - Biochemistry - Cardiology - Dentistry - Dermatology - Drug ADR - Drugs - Embryology - Emergency Medicine - Endocrinology - Epidemiology - Family Medicine - Forensic Medicine - Gastroenterology - Genes - Genetics - Geriatrics - Gynecology - Haematology - Health Informatics - Hepatology - Immunology - Infection - Intensive Care - Medical Dictionary - Medical Education - Medical Statistics - Metabolic Medicine - Microbiology - Nephrology - Neuroanatomy - Neuroscience - Nuclear Medicine - Nutrition - Obstetrics - Occupational Health - Oncology - Ophthalmology - Orthopaedics - Otolaryngology - Paediatrics - Palliative Care - Parasitology - Pathology - Pharmacology - Physiology - Proteomics - Psychiatry - Public Health - Radiology - Respiratory - Rehabilitation - Rheumatology - Sports Medicine - Surgery - Toxicology - Tropical Medicine - Urology - Vascular - Virology.