mesothelioma + Asbestos Flashcards
mesothelial cells come from which germ layer?
Mesoderm
mesothelial membrane lines which structure in the lung?
pleural space
what do mesothelial cells do in response to a noxious stimuli?
proliferate.
is the amount of asbestos exposure related to the severity of mesothelioma?
no
can you get mesothelioma with only low exposure to asbestos?
yes
why does asbestos increase cancer risk?
DNA damaged + altered gene expression from inflammation.
what is the most common asbestos related lung disease?
Pleural plaques
Asbestosis is what exactly?
fibrosis
asbestosis is obstructive or restrictive lung disease?
restrictive
is the amount of asbestos exposure related to the severity/chance of getting asbestosis?
yes
more asbestos = worse asbestosis
asbestos coupled with smoking gives a synergistic increase in risk to what disease?
Lung cancer
someone smokes and has asbestos exposure,
which disease now has a big increase in risk?
Lung cancer
Mesothelioma is a cancer of what specific structure in the lung?
pleura
of mesothelioma pts how many has a history of asbestos exposure?
85%
Latent period for mesothelioma?
20-40 years
which types of asbestos is worst for causing mesothelioma?
what is the colour of this asbestos?
Crocidolite
blue
Mesothelioma often causes what pleural disease,
can be seen on CXR?
pleural effusion
main risk factors for mesothelioma?
-3
Old
male
asbestos exposure
can mesothelioma metastasise?
if so to what structure most commonly?
yes
contralateral lung
how will mesothelioma pt describe their chest pain most commonly?
dull, achy diffuse chest pai
can you get pleuritic chest pain with mesothelioma?
yes
can you get haemoptysis with mesothelioma?
no
pt has mesothelioma.
stony dull percussion is noted. what is this specifically a sign of?
pleural effusion
symptoms of mesothelioma?
- 8
Progressive SOB Cough Chest pain – dull, achy Pleuritic chest pain Fatigue fever night sweats weight loss
pt arrives with cough, SOB, chest pain and history of asbestos exposure.
what is 1st line Ix?
CXR
features of mesothelioma on a CXR?
- 3 things
pleural effusion
pleura thickened
lower zone fibrosis
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
Contrast enhanced CT
pleural thickened, pleural effusion, big lymph nodes
CXR shows pleural effusion.
what Ix would you do now specifically in regards to the pleural effusion.
aspirate and send to lab.
what is the Gold.S Ix for diagnosing mesothelioma?
Thoracoscopy with biopsy
you want to do thoracoscopy to check for mesothelioma, but this is CI.
alternative Ix to thoracoscopy in this context?
image guided fine needle biopsy
most mesothelioma pts will have what treatment?
chemotherapy
what surgery is potentially available for mesothelioma?
- 2
pneumonectomy
pleurectomy
why is surgery normally contraindicated in mesothelioma pts?
because of metastases
in regards to mesothelioma which chemicals are used in chemotherapy?
- 2
Cisplatin
Pemetrexed
median survival for mesothelioma?
1 year
define pneumonectomy
remove part of lung
according to oxford handbook you usually need a biopsy to diagnose.
true or false?
true
other mesothelial layers in the abdomen are never effected by asbestos exposure.
true or false?
false
are effected, but very rarely
is radiotherapy a risk factor for mesothelioma?
yes
is chemotherapy a risk factor for mesothelioma?
no
which virus is a risk factor for mesothelioma?
simian virus 40
when is thoracoscopy indicated as an IX for suspected mesothelioma?
when aspiration and lab analysis of pleural effusion is inconclusive/CI.
