PANCE Pulmonology Practice Test

Asbestos exposure causes chronic lung disease that often shows both interstitial fibrosis (asbestosis) and pleural involvement. The classic setting is work with ships and insulation, where asbestos was heavily used. Pleural plaques—calcified fibrous thickenings on the diaphragmatic or lateral pleura—are a hallmark imaging finding associated with prior asbestos exposure. They can occur with or without significant lung fibrosis and are strong evidence of past exposure. Coal mining causes coal workers’ pneumoconiosis with nodules and progressive fibrosis, not the pleural plaques typical of asbestos. Sandblasting can expose to silica, leading to silicosis with upper-lobe nodules and eggshell calcifications, not the pleural plaques typical of asbestos. Welding fumes may cause metal-related lung changes but are not the classic source of pleural plaques. Therefore, exposure to ships and insulation with pleural plaques best fits as the asbestos-associated pattern.