Condition- pneumoconiosis Flashcards
What sort of lung disease is pneumoconiosis? What causes it?
A fibrosing (restrictive) interstitial lung disease.
Caused by occupational exposure to mineral/ metal dusts
List some types of pneumoconiosis…
- Coal-worker’s pneumoconiosis- caused by chronic inhalation of coal dust
- Silicosis
- Asbestosis
How long does it take between first exposure to mineral dusts and development of pneumoconiosis?
15-20yrs (so if case says he used to be a coal worker 20yrs ago…;))
Descibe the pathophysiology and the events leading from inhalation of coal dust to development of pneumoconiosis…
- Coal dust inhaled
- Coal dust reaches terminal bronchioles and is engulfed by alveolar and interstitial macrophages
- Macrophages die and release hydrolytic enzymes
- Inflammation + fibrin deposition=> fibrosis
List some of the presenting symptoms of pneumoconsiosis
- Dry Cough
- insidious onset of SOBOE
- Black sputum= melaenoptysis
- Can get pleuritic chest pain (e.g. in asbestosis)
List some signs of pneumoconiosis on clinical examination
Clubbing
End inspiratory crackles
Decreased breath sounds
Signs of pleural effusion or RHF (Cor Pulmonale)
List some investigations you could perform on someone presenting with signs and symptoms of pneumoconiosis
- Spirometry
- CXR
What would you see on a spirometry of someone with pneumoconiosis?
Restrictive Lung Function
- Reduced FVC
- Normal or increased FEV1/FVC ratio
- All lung volumes reduced
What might you see on a CXR of someone with simple Pneumoconiosis?
Micronodular mottling- some small rounded opacities but normal lung markings visible= ground glass shadowing
What might you see on a CXR of someone with complex Pneumoconiosis?
Large number of nodular opacities and micronodular shadowing making it difficult to see normal lung markings
May get eggshell calcification of hilar lymph nodes (characteristic of silicosis)
