Asbestos-Related Lung Disease Flashcards

1
Q

how many years after initial exposure to asbestos does asbestosis occur

A

10 years or more after

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2
Q

what is asbestos

A

a naturally occurring fibrous silicate mineral

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3
Q

what is asbestosis

A

diffuse interstitial fibrosis of the lung due to asbestos exposure and inhalation

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4
Q

what are some pleural abnormalities caused by asbestos inhalation

A

plaques that may or may not have calcified,

pleural thickening,

benign pleural effusions,

rounded atelectasis

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5
Q

risk factors

A

occupational exposure,
exposure for a long time,
smoking history

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6
Q

symptoms

A

dyspnoea on exertion, persistent dry cough, chest pain, loss of appetite, shortness of breath

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7
Q

signs

A

fingernails clubbing, crackles heard on auscultation,

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8
Q

where are crackles initially heard

A

bases of the lungs

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9
Q

what is the first line investigation

A

CXR

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10
Q

what would a posterior-anterior and lateral chest X-ray show

A

interstitial fibrosis in the lower zones of lungs and bilateral pleural thickening

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11
Q

what does fibrosis look like

A

irregular opacities and interstitial shadowing

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12
Q

what other investigations will be done

A

pulmonary function tests, CT chest

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13
Q

through pulmonary function tests, what would indicate restrictive changes

A

reduced forced vital capacity (FVC), normal FEV1/FVC ratio, reduced slow vital capacity (SVC), reduced total lung capacity (TLC), reduced lung diffusion capacity testing (DLCO)

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14
Q

what would indicate obstructive changes

A

reduced FEV1, reduced FEV1/FVC ratio, increased residual volume/TLC ratio, reduced DLCO

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15
Q

what changes are mainly seen in asbestosis

A

restrictive

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16
Q

when may a mix of restrictive and obstructive changes be seen

A

smoking history

17
Q

1st line treatment/management

A

smoking cessation advice plus supportive care

some patients may need pulmonary rehab and oxygen therapy

18
Q

what does supportive care involve

A

Antibiotics should be given if there is evidence of infection, such as change in sputum production, fever and increasing dyspnoea.

Patients with evidence of obstructive airways disease should receive appropriate bronchodilator therapy.

19
Q

2nd line treatment

A

pleural decortication or lung transplant

20
Q

what is pleural decortication

A

opening chest cavity and removing the pleural lining

21
Q

possible complications

A

cor pulmonale, lung cancer, mesothelioma

22
Q

prognosis

A

related to the degree of fibrosis and exposure.

smoking cessation results in a good prognosis