Agency for Toxic Substances and Disease Registry
Case Studies in Environmental Medicine (CSEM) 

Asbestos Toxicity
Posttest Instructions

Introduction

ATSDR seeks feedback on this course so we can assess its usefulness and effectiveness. We ask you to complete the assessment questionnaire online for this purpose.

In addition, if you complete the Posttest online, you can receive continuing education credits as follows:

Accreditation Council for Continuing Medical Education (ACCME)

The Centers for Disease Control and Prevention (CDC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. CDC designates this educational activity for a maximum of 2 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC), Commission on Accreditation

This activity for 2 contact hours is provided by the Centers for Disease Control and Prevention, which is accredited as a provider of continuing education in nursing by the American Nurses Credentialing Center's Commission on Accreditation.

National Commission for Health Education Credentialing, Inc. (NCHEC)

The Centers for Disease Control and Prevention is a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is a designated event for the Certified Health Education Specialist (CHES) to receive 2 Category I contact hours in health education, CDC provider number GA0082.

International Association for Continuing Education and Training (IACET)

The Centers for Disease Control and Prevention (CDC) has been reviewed and approved as an Authorized Provider by the International Association for Continuing Education and Training (IACET), Suite 800, McLean, VA 22102. CDC will award 0.2 of CEU's to participants who successfully complete this program.

Disclaimer

In compliance with continuing education requirements, all presenters must disclose any financial or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters as well as any use of unlabeled product(s) or product(s) under investigational use.

CDC/ATSDR, our planners, and the presenters for this seminar do not have financial or other relationships with the manufacturers of commercial products, suppliers of commercial services or commercial supporters. This presentation does not involve the unlabeled use of a product or product under investigational use.

Online Instructions

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Posttest

1. What Is asbestos?
   1. A group of naturally occurring fibrous silicate minerals.
   2. A fibrous substance used widely throughout the United States in the construction, shipbuilding, and automotive industries until the 1970s.
   3. A heat-stable substance commonly used in insulation, pipe coverings, boilers, brake pads, and many other products.
   4. All of the above.
2. Which asbestos exposure pathway most commonly leads to illness?
   1. Ingestion.
   2. Inhalation.
   3. Dermal contact.
   4. All are equally important.
3. Of the following, in the United States, the people in the general population most at risk of exposure to asbestos today is
   1. people who work in asbestos mining and milling.
   2. household contacts of workers engaged in the manufacture of asbestos-containing products.
   3. people working or living in homes and buildings with loose, crumbling, or disturbed asbestos materials.
   4. people who garden with vermiculite potting soil.
4. OSHA requires workers who are exposed to asbestos at levels higher than the PEL of 0.1 fibers/cc of air (8-hour TWA) to
   1. receive medical surveillance.
   2. be hospitalized immediately.
   3. file claims for work-related injuries.
   4. All of the above.
5. After inhalation, asbestos fibers
   1. are retained in the lungs, especially the lower lung fields.
   2. initiate responses that can lead to fibrosis of lung tissue.
   3. initiate responses that can lead to carcinogenesis.
   4. All of the above.
6. Of the four respiratory conditions associated with asbestos exposure, the condition that is not malignant but is associated with significant restrictive deficits is
   1. parenchymal asbestosis.
   2. asbestos-related pleural abnormalities.
   3. lung carcinoma.
   4. pleural mesothelioma.
7. Which condition is most likely to occur secondary to asbestos-associated pulmonary fibrosis?
   1. Peritoneal mesothelioma.
   2. Colon cancer.
   3. Cor Pulmonale.
   4. Constrictive pericarditis.
8. The most important risk factor for asbestos-associated diseases are
   1. genetic polymorphisms and exposure to air pollution.
   2. total exposure to asbestos and smoking.
   3. frequency of respiratory infections and coexistence of other fibrotic respiratory conditions.
   4. all are equally important.
9. A 64-year-old male who worked in shipyards in the United States in the 1960s and 1970s presents to his physician complaining of breathlessness, especially when he works or exercises. He says this symptom began several years ago but was so minor that he was not concerned. He also complains of a slight, nagging dry cough. Of the asbestos-associated diseases, the most likely culprit is
   1. parenchymal asbestosis.
   2. asbestos-related pleural abnormalities.
   3. lung carcinoma.
   4. pleural mesothelioma.
10. On auscultation of the patient described above, you are most likely to hear
    1. normal breath sounds.
    2. absent breath sounds.
    3. bibasilar end inspiratory rales.
    4. rhonchi.
11. As part of taking the exposure history, you should explore
    1. possible occupational exposures to asbestos.
    2. possible paraoccupational and secondary exposures to asbestos.
    3. use of personal protective equipment.
    4. All of the above.
12. Pulmonary function tests of a patient with parenchymal asbestosis are most likely to show
    1. normal results.
    2. low FVC.
    3. low FEV1.
    4. low FEV1/FVC.
13. On chest radiograph, small, irregular opacities in the bases of both lung fields is suggestive of
    1. parenchymal asbestosis.
    2. pleural plaques.
    3. benign asbestos pleural effusion.
    4. diffuse pleural thickening.
14. In caring for a patient who was exposed to asbestos, it is important to
    1. take steps to avoid further exposure to asbestos.
    2. counsel the patient to stop smoking.
    3. monitor the patient to facilitate early diagnosis.
    4. All of the above.
15. Patients diagnosed with an asbestos-associated disease should be instructed to
    1. continue working with asbestos as long as they use PPE.
    2. contact their doctor if they develop any sign of respiratory infection or other health change.
    3. receive influenza and pneumococcal vaccines only if they meet other criteria for being high risk.
    4. All of the above.
16. Asbestos fibers are released into the air mainly when
    1. asbestos-containing materials are loose, crumbling, or disturbed.
    2. asbestos is fixed in solid materials such as wallboard.
    3. asbestos-bearing rock lays unexposed deep underground.
    4. All of the above.
17. EPA’s MCL for asbestos in drinking water is which of the following?
    1. 0.07 fibers per liter of drinking water.
    2. 7 million fibers per liter of drinking water.
    3. 700 fibers per liter of drinking water.
    4. 70,000 fibers per liter of drinking water.
18. Diffuse interstitial fibrosis resulting from inhalation of asbestos fibers and producing restrictive lung disease and progressive exertional dyspnea is termed
    1. lung carcinoma.
    2. pleural mesothelioma.
    3. parenchymal asbestosis.
    4. asbestos-related pleural abnormalities.
19. Asbestos-related pleural abnormalities include which of the following?
    1. Pleural plaques.
    2. Benign pleural effusions and diffuse pleural thickening.
    3. Rounded atelectasis.
    4. all of the above
20. The most typical abnormal finding on physical examination of a patient with significant asbestosis is
    1. a “doughy” feeling in the abdomen.
    2. bibasilar inspiratory rales on pulmonary auscultation.
    3. clubbing of the fingers.
    4. All of the above.
21. The two most important tests for diagnosing asbestos-associated diseases are
    1. BAL and lung biopsy.
    2. CT and HRCT scans.
    3. chest radiograph and pulmonary function tests.
    4. blood studies and colon cancer screening.
22. Managing parenchymal asbestosis involves
    1. smoking cessation.
    2. regular influenza and pneumococcal vaccines.
    3. respiratory therapies and pulmonary rehabilitation.
    4. All of the above.
23. Patients who were exposed to asbestos should
    1. stop smoking.
    2. avoid exposure to other respiratory irritants.
    3. avoid exposure to respiratory infections and contact their doctor if they get signs of infection or other health changes.
    4. all of the above

Relevant Content

To review content relevant to the posttest questions, see: