mesothelioma + Asbestos

Question 1

mesothelial cells come from which germ layer?

Answer 1

Mesoderm

Question 2

mesothelial membrane lines which structure in the lung?

Answer 2

pleural space

Question 3

what do mesothelial cells do in response to a noxious stimuli?

Answer 3

proliferate.

Question 4

is the amount of asbestos exposure related to the severity of mesothelioma?

Answer 4

no

Question 5

can you get mesothelioma with only low exposure to asbestos?

Answer 5

yes

Question 6

why does asbestos increase cancer risk?

Answer 6

DNA damaged + altered gene expression from inflammation.

Question 7

what is the most common asbestos related lung disease?

Answer 7

Pleural plaques

Question 8

Asbestosis is what exactly?

Answer 8

fibrosis

Question 9

asbestosis is obstructive or restrictive lung disease?

Answer 9

restrictive

Question 10

is the amount of asbestos exposure related to the severity/chance of getting asbestosis?

Answer 10

yes

more asbestos = worse asbestosis

Question 11

asbestos coupled with smoking gives a synergistic increase in risk to what disease?

Answer 11

Lung cancer

Question 12

someone smokes and has asbestos exposure,

which disease now has a big increase in risk?

Answer 12

Lung cancer

Question 13

Mesothelioma is a cancer of what specific structure in the lung?

Answer 13

pleura

Question 14

of mesothelioma pts how many has a history of asbestos exposure?

Answer 14

85%

Question 15

Latent period for mesothelioma?

Answer 15

20-40 years

Question 16

which types of asbestos is worst for causing mesothelioma?

what is the colour of this asbestos?

Answer 16

Crocidolite

blue

Question 17

Mesothelioma often causes what pleural disease,

can be seen on CXR?

Answer 17

pleural effusion

Question 18

main risk factors for mesothelioma?

-3

Answer 18

Old
male
asbestos exposure

Question 19

can mesothelioma metastasise?

if so to what structure most commonly?

Answer 19

yes

contralateral lung

Question 20

how will mesothelioma pt describe their chest pain most commonly?

Answer 20

dull, achy diffuse chest pai

Question 21

can you get pleuritic chest pain with mesothelioma?

Answer 21

yes

Question 22

can you get haemoptysis with mesothelioma?

Answer 22

no

Question 23

pt has mesothelioma.

stony dull percussion is noted. what is this specifically a sign of?

Answer 23

pleural effusion

Question 24

symptoms of mesothelioma?

- 8

Answer 24

Progressive SOB 
Cough 
Chest pain – dull, achy 
Pleuritic chest pain 
Fatigue
fever
night sweats
weight loss

Question 25

pt arrives with cough, SOB, chest pain and history of asbestos exposure. what is 1st line Ix?

Answer 25

CXR

Question 26

features of mesothelioma on a CXR? | - 3 things

Answer 26

pleural effusion pleura thickened lower zone fibrosis

Question 27

pt has CXR with findings suspicious of mesothelioma. What is the next imaging Ix? what counts as positive finding for mesothelioma on this IX? - 3 things

Answer 27

Contrast enhanced CT pleural thickened, pleural effusion, big lymph nodes

Question 28

CXR shows pleural effusion. what Ix would you do now specifically in regards to the pleural effusion.

Answer 28

aspirate and send to lab.

Question 29

what is the Gold.S Ix for diagnosing mesothelioma?

Answer 29

Thoracoscopy with biopsy

Question 30

you want to do thoracoscopy to check for mesothelioma, but this is CI. alternative Ix to thoracoscopy in this context?

Answer 30

image guided fine needle biopsy

Question 31

most mesothelioma pts will have what treatment?

Answer 31

chemotherapy

Question 32

what surgery is potentially available for mesothelioma? | - 2

Answer 32

pneumonectomy pleurectomy

Question 33

why is surgery normally contraindicated in mesothelioma pts?

Answer 33

because of metastases

Question 34

in regards to mesothelioma which chemicals are used in chemotherapy? - 2

Answer 34

Cisplatin | Pemetrexed

Question 35

median survival for mesothelioma?

Answer 35

1 year

Question 36

define pneumonectomy

Answer 36

remove part of lung

Question 37

according to oxford handbook you usually need a biopsy to diagnose. true or false?

Answer 37

true

Question 38

other mesothelial layers in the abdomen are never effected by asbestos exposure. true or false?

Answer 38

false | are effected, but very rarely

Question 39

is radiotherapy a risk factor for mesothelioma?

Answer 39

yes

Question 40

is chemotherapy a risk factor for mesothelioma?

Answer 40

no

Question 41

which virus is a risk factor for mesothelioma?

Answer 41

simian virus 40

Question 42

when is thoracoscopy indicated as an IX for suspected mesothelioma?

Answer 42

when aspiration and lab analysis of pleural effusion is inconclusive/CI.