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A 64 year old Scandinavian immigrant has been having shortness of breath and productive cough for several months. His history is significant for 20 pack years of smoking and working as a coal miner for 35 years. Brought to the ER because recently his dyspnea worsened and his wife blood in his sputum. Physical examination revealed wide spread crackles and wheezes in both lung fields. Chest X ray was significant for a number of 10 mm sized nodules in both upper zones. Lung biopsy performed and malignancy was ruled out.
What is the most probable diagnosis?

A- Asbestosis
B- Silicosis
C- Coal Miner's Lung
D- Tuberculosis
E- Sarcoidosis
 

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Coal miner pneumoconiosis! C.

Interestingly though that silicosis is also in the options. Coal dust has silica!

Cause of Silicosis

Silicosis is the result of inhalation of silica dust, mainly from industrial sources such as:

  • Flint Ceramics
  • Sandstone Building Material, Cement
  • Silica Flour Materials in paint, porcelain, scouring soaps, wood fillers
  • Quartz Gold, lead, coal, and zinc mining

People who are most likely to develop silicosis are those who are continually exposed to silica dust due to their working environment. These include:

  • Foundry workers
  • Miners
  • Stonecutters
  • Grinders
  • Boiler scalers
  • Sand blasters
  • Tunnel workers
 

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A 64 year old Scandinavian immigrant has been having shortness of breath and productive cough for several months. His history is significant for 20 pack years of smoking and working as a coal miner for 35 years. Brought to the ER because recently his dyspnea worsened and his wife blood in his sputum. Physical examination revealed wide spread crackles and wheezes in both lung fields. Chest X ray was significant for a number of 10 mm sized nodules in both upper zones. Lung biopsy performed and malignancy was ruled out.
What is the most probable diagnosis?

A- Asbestosis
B- Silicosis
C- Coal Miner's Lung
D- Tuberculosis
E- Sarcoidosis
I think the answer is Silicosis

Silicosis is far more common than Coal Miner's Lung, and also the progression to fibrosis is more frequently in silicosis.
 
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