A man who worked for years in a shipyard has progressive breathlessness, finger clubbing and bibasal fine end-inspiratory crackles. Lung function tests are most likely to show what?
Answer and explanation
Correct answer: B. A restrictive pattern with a reduced FVC and a normal or raised FEV1/FVC ratio
- Step 1: Asbestos-related pulmonary fibrosis (asbestosis) is an interstitial lung disease. Step 2. Interstitial disease stiffens the lung, reducing volumes, so FVC falls while the ratio stays normal or high, and gas transfer is reduced. Answer: A restrictive pattern with a reduced FVC and a normal or raised FEV1/FVC ratio. Why not the others: An obstructive picture suggests COPD or asthma. A raised residual volume is a feature of air trapping. Complete reversibility is typical of asthma.
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