Asbestos-Related Lung Disease Flashcards
how many years after initial exposure to asbestos does asbestosis occur
10 years or more after
what is asbestos
a naturally occurring fibrous silicate mineral
what is asbestosis
diffuse interstitial fibrosis of the lung due to asbestos exposure and inhalation
what are some pleural abnormalities caused by asbestos inhalation
plaques that may or may not have calcified,
pleural thickening,
benign pleural effusions,
rounded atelectasis
risk factors
occupational exposure,
exposure for a long time,
smoking history
symptoms
dyspnoea on exertion, persistent dry cough, chest pain, loss of appetite, shortness of breath
signs
fingernails clubbing, crackles heard on auscultation,
where are crackles initially heard
bases of the lungs
what is the first line investigation
CXR
what would a posterior-anterior and lateral chest X-ray show
interstitial fibrosis in the lower zones of lungs and bilateral pleural thickening
what does fibrosis look like
irregular opacities and interstitial shadowing
what other investigations will be done
pulmonary function tests, CT chest
through pulmonary function tests, what would indicate restrictive changes
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)
what would indicate obstructive changes
reduced FEV1, reduced FEV1/FVC ratio, increased residual volume/TLC ratio, reduced DLCO
what changes are mainly seen in asbestosis
restrictive
when may a mix of restrictive and obstructive changes be seen
smoking history
1st line treatment/management
smoking cessation advice plus supportive care
some patients may need pulmonary rehab and oxygen therapy
what does supportive care involve
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.
2nd line treatment
pleural decortication or lung transplant
what is pleural decortication
opening chest cavity and removing the pleural lining
possible complications
cor pulmonale, lung cancer, mesothelioma
prognosis
related to the degree of fibrosis and exposure.
smoking cessation results in a good prognosis
