Asbestos related disease

Question 1

define asbestosis?

Answer 1

long-term inflammation and scarring of lungs due to inhalation of asbestos fibres

Question 2

define mesothelioma?

Answer 2

aggressive tumour of mesothelial cells that usually occurs in the pleura (90%), and sometimes in peritoneum, pericardium or testes with poor prognosis

Question 3

what are the types of asbestos?

which is the most dangerous?

Answer 3

 Chrysotile (white asbestos) is the least fibrogenic
 Amosite (brown asbestos) has intermediate fibrogenicity
 Crocidolite (blue asbestos) is the most fibrogenic

Question 4

how is asbestos exposure related to disease?

Answer 4

o Degree of exposure is related to degree of asbestosis

o Latent period is typically 15-30 years

Question 5

what else can asbestos exposure cause?

Answer 5

o Asbestos exposure can also cause pleural plaques and thickening which are benign

Question 6

how does exposure of asbestos correlate with mesothelioma?

Answer 6

o Any degree of exposure can cause mesothelioma

o The latent period can be up to 45 yrs

Question 7

epidemiology of asbestos disease?

Answer 7

• common in elderly people

- history is important take note of occupation.

Question 8

presenting complaints of asbestosis?

Answer 8

Progressive dyspnoea

Question 9

presenting complaint of mesothelioma?

Answer 9

o     SOB, chest pain weight loss 
o	Fatigue 
o	Fever 
o	Night sweats 
o	Bone pain 
o      Bloody sputum

Question 10

signs of asbestosis?

Answer 10

o Clubbing
o Fine bi-basal end-inspiratory crackles
LOWER LOBES AFFECTED

Question 11

signs of mesothelioma?

Answer 11

o	Occasional palpable chest wall mass 
o	Clubbing
o	Recurrent pleural effusions 
o	Signs of metastases
o	Can rarely cause pneumothorax

Question 12

investigations for asbestosis?

Answer 12

o Hx and examination
o CXR:
shadowing +/- pleural plaques

Question 13

investigations for mesothelioma?

Answer 13

o	CXR
	Pleural thickening/effusion  
	Bloody pleural fluid 
	May show pleural mass 
o	MRI and PET 
o	Pleural fluid: can be sent for cytological analysis

Question 14

how is diagnosis for mesothelioma made?

Answer 14

on histology