sandra
Forum Guru
Topics: 200
Posts: 468
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A 60-year-old man comes to the physician because of increasing shortness of breath for 1 week;
it occurs at rest and is exacerbated by exertion. He has not had chest pain. He has smoked two
packs of cigarettes daily for 40 years. Between the ages of 18 and 30 years, he worked in a
warehouse with exposed bare insulation; for the past 15 years, he has driven a taxi. Medications
include ipratropium bromide and albuterol metered-dose inhalers. His temperature is 37 C (98.6 F),
blood pressure is 170/95 mm Hg, pulse is 100/min, and respirations are 24/min. Anterior and
posterior diffuse wheezes are heard. Cardiac examination shows no murmurs. There is mild pretibial
edema. An x-ray film of the chest shows calcified pleural plaques on the right hemidiaphragm and a
2-cm pleural-based mass. With regard to the findings on the x-ray film, which of the following is
most likely to have prevented this patient's condition?
A
) Appropriate immunizations
B
) Different occupation
C
) Different medications
D
) Hypertension screening
E
) Smoking cessation
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| docnikki
Forum Guru
Topics: 93
Posts: 680
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E. Smoking cessation or B Different occupation...
Asbestosis complicated by pleural mesothelioma...it occurs when person concommitantly smokes. but it could have been prevented if he wasnt in that occupation at all...so Im confused.
I go with B!
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| farnsworth
Forum Newbie
Topics: 0
Posts: 165
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The pleural mesothelioma is most likely caused by asbestos, but I think the SOB is caused by smoking (obstructive component, therefore the patient uses albuterol and ipatropium bromide). Asbestosis is a restrictive disease also presenting w/ SOB, but bronchodilators have not been proven useful.
So I would go for E
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