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Year 3 > Asbestos Related Lung Disease > Flashcards

Asbestos Related Lung Disease Flashcards

1
Q

What is Asbesttosis?

A

Interstitial restrictive lung disease:

  • diffuse interstitial fibrosis due to exposure to asbestos fibres
  • Pleural abnormalities may be present with or without parenchymal fibrosis
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2
Q

What is the Aetiology of Asbestosis?

A

Inhalation of Asbestos fibres

  • The more the higher the risk
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3
Q

What are the risk factors for the development of Asbestosis?

A
  • Cumulative dose of inhaled asbestos (occupational construction or ship workers)
  • Smoking (weak)
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4
Q

What is the epidemiology of Asbestosis?

A
  • Incidence increasing
  • Latency of about 20 years between first exposure and asbestosis
  • Ofen >50, male (due to occumpation) (1-2% female)
  • 2016: 1050 new cases of asbestosis in the UK
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5
Q

How do Asbestos Fibres in the lungs cause asbestosis?

A
  1. Asbestos fibres inhaled –> deposition at alveolar duct bifurcation (too small so be coughed up, too big to be successfully removed my immune cells) –> attraction of macrophages –> Alveolar macrophage alveolitis
  2. Cytokine release –> Fibrosis (ususally starting in lower lobes) and later Honeycombing
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6
Q

What are the presenting symptoms of Asbestosis?

A
  • Restrictive lung disease
    • Chest tighness
    • dyspnoea on exertion
    • dry, non-productive cough
    • Getting progressively worse
    • Normally no chest pain
    • (Later: Symptoms of Cor Pulmonale)
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7
Q

What are signs on examination of Asbestosis?

A
  • Crackels (fine, often bibasal crackels)
    • late inspiratory
  • Clubbing
  • Cyanosis
  • Decreased chest expansion
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8
Q

Which investigations would you do in a patient with suspected Asbestosis?

A
  1. CXR
  2. Pulmonary function test
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9
Q

What are the findings in a CXR in a patient with Asbestosis?

A
  • linear interstitial changes, first seen in lower lobe
  • Pleural plaques
    • Pleural thickening at the mid-thoracic level may be present alone or in conjunction with linear changes in the parenchyma
  • Majority of pleural changes not calcified –> not visible on X-Ray
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10
Q

What are your finding in a spiromtry /Pulmonary function test of a patient with Asbestosis?

A

Restrictive Lung disease

  • Restrictive Pulmonary Disease
  • Reduction in FVC, FEV1
  • Normal FEV1 to FVC ratio
  • Reduced vital/total lung capacity
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11
Q

What is Mesothelioma?

A

Aggressive Malignancy of mesothelium normally found in the Pleura (90%), but might be also seen in Peritoneum (5-10%). This article: Pulmonary

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12
Q

What is the Mesotheliom?

A

Single-cell membrane lining several body cavities and interstital organs

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13
Q

What is the epidemiology of a Mesothelioma?

A
  • Men
  • White
  • Older adults (60-90) –> due to occupational exposure and risk factors
  • Relativeyl rare expected to peak between 2011 and 2015, with 1950 to 2450 deaths
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14
Q

What is the Aetiology of a Mesothelioma?

A

Asbestos exposure (80% of patients)

Latency 20-40 years after exposure

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15
Q

What are risk factors for the development of a mesothelioma?

A
  • Asbestos exposure
  • Smoking
    *
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16
Q

Explain the pathophysiology of Asbestos related mesothelioma

A
  1. Asbestos fibres get inhaled, wonder in tissues until they get to epithelium of lung (mesothelium)
  2. Cause irritation –> inflammation might lead to DNA damage –> mutation and malignancy
17
Q

What are the symptoms of a pleuritic Mesothelioma?

A

Symptoms of Asbestosis

  • SOB
  • Dry, non-productive cough
  • Chest pain
  • Haemoptysis
  • Systemic
  • Fever, night sweat, lethargy, weight losss
18
Q

What are signs of a pleuritis Mesothelioma?

A
  • Due to pleural effusion
    • Decreased breath sounds
    • can also indicate trapped lung or bronchial obstruction caused by mesothelioma
    • Dullness to percussion
19
Q

Which investigations would you consider in someone with a suspected Mesothelioma?

A
  • ImagingCXR (not very sensitive)
  • If suspected mesothelioma: CT
    • circumferential or nodular pleural thickening or involvement of the mediastinal pleura
  • Pulmonary function test
  • Biopsy
20
Q

What is the prognosis in a patien with suspected Mesothelioma?

A
  • Poor
  • median survival is 10 to 15 months, with only 5% to 10% of patients alive 5 years after diagnosis
21
Q

What are the findings on an X-Ray that you would expect in a patient with Mesothelioma?

A
  • unilateral pleural effusion
  • pleural thickening
  • reduced lung volumes, or parenchymal changes related to asbestos exposure

Year 3 (52 decks)

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