Coal worker's pneumoconiois question,,,,,,,,

[Knicks]

I was reading the RR Path book and on page 307 it says, "No increased incidence of TB or primary lung cancer". (notice the italicized "No").

However, at a study session at a classmate's house (during which he was playing the goljan audio that he had, on his speakers) goljan says that these patients DO have an increased incidence of TB but not cancer.


Why the discrepancy? Which is correct?

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[soonereng]

I was reading the RR Path book and on page 307 it says, "No increased incidence of TB or primary lung cancer". (notice the italicized "No").

However, at a study session at a classmate's house (during which he was playing the goljan audio that he had, on his speakers) goljan says that these patients DO have an increased incidence of TB but not cancer.


Why the discrepancy? Which is correct?

According to Robbins the RR book is correct.

Unlike silicosis...there is no convincing evidence that coal dust increases susceptibility to tuberculosis...To date however, there is no compelling evidence that CWP in the absence of smoking predisposes to cancer.

 

[spospo]

i was in this similar position a few weeks ago. one professor said yes while goljan said no. very confused with the final coming up, i emailed the head of pathology. he basically said

recent evidence suggests CWP and TB are independent BUT miners have an increased risk of TB, which has often been assumed to be due to the coal dust. more often though people link the TB in coal workers with poor general health, poor nutrition, etc

hope that helps

 

[Amy B]

I work in an area that has a high rate of black lung. Some have also had TB, none have had cancer......

 

[Knicks]

Thanks everyone for the input.

Robbins, it is.

 

[AllUpOnYoMama]

They have an increased risk of TB but not cancer. I would go with robbins over old audio goljan anyday. I also think that I had this question in USMLEworld. peace

 

[IdontTakeCall]

according to my path notes from my pulmonology unit, silicosis, not coal workers pneumo, leads to an increased lifetime chance of Tuberculosis. Asbestosis and silicosis both have an increased chance of cancer particularly mesothilioma with asbestosis. Very similar diseases that do not predispose to the same future illnesses.

 

[AllUpOnYoMama]

according to my path notes from my pulmonology unit, silicosis, not coal workers pneumo, leads to an increased lifetime chance of Tuberculosis. Asbestosis and silicosis both have an increased chance of cancer particularly mesothilioma with asbestosis. Very similar diseases that do not predispose to the same future illnesses.

Forget about asbestosis/smokers and mesothelioma. Most pts with asbestos exposure who also smoke die from lung cancer way before they have mesothelioma. I believe it takes 20 years for mesothelioma to grow vs. 10 or so for lung cancer. Im not sure what type of lung cancer. I think asbestosis and mesothelioma is too easy for the board to ask. Someone correct me if Im wrong. I think I read this in goljan RR.

 

[Disinence2]

So was the verdict on this that CWP has no increased incidence of TB or primary lung cancer?

I spent some time on Pub Med but couldn't come up with anything.

Thanks!

 

[___Doctor786___]

I'm not sure about Coal-worker's pneumoconiosis, however, with Silicosis, there is definitely an increased risk of TB.

 

[Depakote]

For Coal Worker's Pneumoconiosis, my path notes say explicitly (and I'm quoting from the slide):

Increased incidence of:
-Tuberculosis
-Chronic Bronchitis
-Emphysema

Does not predispose to cancer

(edit: see below... flip flopping on this)

 

[Depakote]

For Coal Worker's Pneumoconiosis, my path notes say explicitly (and I'm quoting from the slide):

Of course, I go to Medium Robbins to get a page reference and on p271 I see:

Unlike with silicosis (later) there is no convincing evidence that coal dust increases susceptibility to contracting tuberculosis.

*shrug*

 

[Knicks]

ughhhhh,


the ambiguity is annoying.