12-17-2007, 08:18 AM
A 60-year-old male is seen in the clinic for counseling about asbestos exposure. He is well and has no
symptoms. He also has hypertension, for which he takes hydrochlorothiazide. The patient smokes one
pack of cigarettes a day but has no other habits. He is currently retired but worked for 30 years as a
pipefitter and says he was around "lots" of asbestos, often without wearing a mask or other protective
devices. Physical examination is normal except for nicotine stains on the left second and third fingers.
Chest radiography shows pleural plaques but no other changes. Pulmonary function tests, including lung
volumes, are normal. Which of the following statements should be made to this patient?
A. He must quit smoking immediately as his risk of emphysema is higher than that of other smokers
because of asbestos exposure.
B. He does not have asbestosis.
C. His risk of mesothelioma is higher than that of other patients with asbestos exposure because he has
a history of tobacco use.
D. He has no evidence of asbestos exposure on chest radiography.
E. He should undergo biannual chest radiography screening for lung cancer
symptoms. He also has hypertension, for which he takes hydrochlorothiazide. The patient smokes one
pack of cigarettes a day but has no other habits. He is currently retired but worked for 30 years as a
pipefitter and says he was around "lots" of asbestos, often without wearing a mask or other protective
devices. Physical examination is normal except for nicotine stains on the left second and third fingers.
Chest radiography shows pleural plaques but no other changes. Pulmonary function tests, including lung
volumes, are normal. Which of the following statements should be made to this patient?
A. He must quit smoking immediately as his risk of emphysema is higher than that of other smokers
because of asbestos exposure.
B. He does not have asbestosis.
C. His risk of mesothelioma is higher than that of other patients with asbestos exposure because he has
a history of tobacco use.
D. He has no evidence of asbestos exposure on chest radiography.
E. He should undergo biannual chest radiography screening for lung cancer