A 55-year-old stone worker presents with a 5-year history of increasing shortness of breath. Chronic inhalation of quartz (silicon dioxide) in this patient most likely caused which of the following lung diseases?
Asthma
Atelectasis
Bronchiectasis
Emphysema
Pneumoconiosis
The Correct Answer is E
A. Asthma: Asthma is a chronic inflammatory airway disorder usually triggered by allergens or atopy. While inhaled irritants may exacerbate asthma symptoms, it is not caused by chronic silica exposure and does not produce the fibrotic changes seen in occupational lung diseases.
B. Atelectasis: Atelectasis refers to the collapse of alveoli, usually secondary to obstruction, compression, or surfactant deficiency. It is not a primary disease caused by chronic inhalation of silica dust and does not explain the progressive dyspnea over years in this patient.
C. Bronchiectasis: Bronchiectasis involves permanent dilation of bronchi, often following repeated infections or severe airway obstruction. Chronic silica exposure typically causes interstitial fibrosis rather than bronchial dilation, making bronchiectasis less likely in this occupational scenario.
D. Emphysema: Emphysema is characterized by alveolar wall destruction and airspace enlargement, most commonly due to smoking or alpha-1 antitrypsin deficiency. While dust exposure may contribute to obstructive changes, the fibrotic response from silica inhalation leads to a restrictive pattern rather than classic emphysema.
E. Pneumoconiosis: Pneumoconiosis is a fibrotic lung disease caused by chronic inhalation of mineral dusts, including silica. Inhaled quartz particles trigger macrophage-mediated inflammation, collagen deposition, and nodular fibrosis, leading to progressive dyspnea, reduced lung compliance, and radiographic changes typical of silicosis in stone workers.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Congestive heart failure:Congestive heart failure can cause dyspnea and pulmonary congestion, but hemoptysis and sudden pleuritic chest pain are not classic presenting features. CHF-related pulmonary edema usually produces pink, frothy sputum rather than frank blood and develops in the context of volume overload rather than acute embolic events.
B. Cor pulmonale:Cor pulmonale refers to right ventricular hypertrophy and failure secondary to chronic pulmonary hypertension. It develops gradually in patients with chronic lung disease and presents with peripheral edema and fatigue, not sudden chest pain and hemoptysis.
C. Phlebothrombosis:Phlebothrombosis refers to thrombus formation in a vein, often in the lower extremities, especially in patients with varicose veins. While it is the underlying source of emboli, it does not directly cause chest pain or hemoptysis unless a clot dislodges and travels to the lungs.
D. Pulmonary thromboembolism:Pulmonary thromboembolism occurs when a thrombus, often originating from deep leg veins, embolizes to the pulmonary arteries. Sudden chest pain and hemoptysis result from pulmonary infarction and pleural irritation. Varicose veins increase venous stasis, predisposing to thrombosis and subsequent embolism.
E. Pulmonary edema:Pulmonary edema involves fluid accumulation in the alveoli, most commonly due to left-sided heart failure. It causes dyspnea and crackles but does not typically present with sudden pleuritic chest pain and hemoptysis linked to venous thromboembolic risk factors.
Correct Answer is A
Explanation
A. Angina:Chest pain precipitated by exertion and relieved by nitroglycerin is characteristic of stable angina pectoris. It results from transient myocardial ischemia due to a mismatch between oxygen supply and demand, typically caused by atherosclerotic narrowing of coronary arteries. Nitroglycerin relieves pain by causing venodilation, reducing preload and myocardial oxygen demand.
B. Dyspnea:Dyspnea refers to the subjective sensation of shortness of breath. Although it may accompany cardiac ischemia, it is not defined as chest pain and does not specifically describe exertional discomfort relieved by nitroglycerin.
C. Dyspepsia:Dyspepsia describes indigestion or epigastric discomfort related to gastrointestinal causes. While it can sometimes mimic cardiac chest pain, it is unrelated to myocardial ischemia and would not consistently improve with nitroglycerin.
D. Dysphagia:Dysphagia refers to difficulty swallowing and is associated with esophageal or neuromuscular disorders. It does not describe exertional chest pain related to cardiac ischemia.
E. Orthopnea:Orthopnea is shortness of breath that occurs when lying flat and improves with sitting upright, often seen in heart failure. It is distinct from exertional chest pain relieved by nitrates and does not describe anginal symptoms.
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