Asbestos Related Lung Disease Flashcards
What is asbestosis?
diffuse interstitial fibrosis of lung as consequence of exposure to asebestos fibres
When does onset of asbestosis occur?
> 10 years following initial exposure to asbestos
What are RF for asbestosis?
- Asbestos exposure
- Long duration of exposure
- Smoking Hx
What are symptoms of asbestosis?
1. Asymptomatic Or 2. Progressive SOB 3. Haemoptysis 4. FKAWS 5. Dyspnoea on exertion 6. Cough
What are possible DDx for asbestosis?
- Idiopathic pulmonary fibrosis
- Connective tissue disease
- Hypersensitivity pneumonitis (HP)
- Hard metal lung disease
- Silicosis
sarcoidosis - Medication or radiation related Pulmonary fibrosis
What tests would you do for asbestosis?
- CXR - PA and Lateral
2. PFTs
What would CXR PA and lateral show in asbestosis?
- Right sided pleural effusion
- Lower zone liner interstitial fibrosis
- Pleural thickening
- Bilatreal lower fibrosis (if asbestosis)
What would PFTs show in asbestosis?
restrictive changes, maybe obstructive (esp if Hx of smoking)
What are restrictive changes in PFTs?
- Reduced FVC and normal FEV1/FVC ratio
- Reduced SVC
- Reduced TLC
- Reduced DLCO
What are obstructive changes in PFTs?
- Reduced FEV1
- Reduced FEV1/FVC
- Increased RV/LCS ratio
- Reduced DLCO
What is first line management for asbestosis?
1st line: Cig smoking cessation to reduce risk of LC + supportive care
-Adjunct: pulmonary rehab and oxygen therapy
What is 2nd line treatment for asbestosis?
pleural decortication or lung transplant
What are possible complications of asbestosis?
- Cor pulmonlae
- Lung cancer
- Mesothelioma
- Colon cancer
- Laryngeal Cancer
What is the prognosis of asbestosis related to?
extent of fibrosis notes at diagnosis and past cumulative exposure to absbestos
What can asbestosis lead to?
mesothelioma
What type of crystals are in asbestosis?
Serpentine crystals and amphibole crystals
What are signs in asbestosis?
- Fine-end bibasal crackles
- Clubbing
- Asbestos warts
- Reduced expansion
- RHF
What other investigations may be done for asbestosis?
- Lung biopsy if malignant
- ABG if acute as may show T1 resp failure (hypoxia)
- HRCT
What would HRCT show in asbestosis?
- Basal diffuse reticulonodular infiltrates
- Shaggy heart border
- Ground glass and diffuse interstitial fibrosis
Why do you need to do HRCT in all ILD?
as need to know pattern of fibrosis
When can you have compensation for asbestosis?
Compensation for 3 years of diagnosis
What are asbestos bodies?
presence of asbestosis in lungs with no symptoms or CXR findings after light exposure to asbestos
When are pleural plaques seen?
seen early and at low exposure
What are pleural plaques like?
thickening and calcification of the pleura visible on CXR that causes slight restrictive lung disease and rarely causes occasional exertion dyspnoea – can be diffused
