Pulmonology

Start out your Pulmonology block by checking out your Goals and Objectives, which includes the following important topic list to help you focus your attention. You'll notice some pulm-related topics in the Topics lists. For more in-depth learning and resources, click extended versions below:

1. Cystic Fibrosis (Short version learning / Extended version learning)
   • Develop an understanding of the molecular pathogenesis and CFTR dysfunction along with the natural history of the disease
   • Appreciate the myriad of organ system involvement (upper/lower respiratory tract, GI/nutrition, endocrine, reproductive, electrolyte complications, etc.)
   • Recognize infectious complications of CF lung disease (e.g. Pseudomonas aeruginosa, MRSA, Burkholderia cepacia ABPA, nontuberculous mycobacterial infection)
   • Understand the inpatient presentation and the treatment of pulmonary exacerbations and the complications of CF involving other organ systems
   • Appreciate the importance of a multidisciplinary team approach
   • Understand diagnostic testing, including sweat testing, genetic testing and newborn screening
   • Know the basis of CF maintenance therapy and care in an outpatient setting
   • Review the use of CFTR modulator therapies
   • Recognize the importance of therapy adherence and barriers to care
2. Bronchopulmonary Dysplasia (BPD), Chronic Lung Disease of Infancy (CLD-I) (Short version learning / Extended version learning)
   • Know the risk factors, pathogenesis and definitions for BPD
   • Appreciate the differences in epidemiology and pathogenesis of the “new BPD” vs. old BPD.
   • Review the antenatal and postnatal preventative measure that may be taken against BPD.
   • Know the clinical management of respiratory support in infants with BPD in the NICU and outpatient settings.
   • Describe the pharmacologic treatments for BPD.
   • Understand the risk of development of pulmonary hypertension.
   • Recognize the other comorbid respiratory and systemic conditions that are seen in infants with BPD.
   • Understand long-term outcomes of patients with BPD.
   • Recognize the differential diagnoses for BPD and other commonly coexisting diagnoses that may be present.
3. Asthma and other causes of airway reactivity (Short version learning / Extended version learning)
   • Develop an understanding of the pathogenesis and diagnosis of asthma
   • Develop a differential diagnosis for wheeze and cough in early childhood. Understand the relationship between early childhood wheezing, chronic cough and asthma
   • Understand the National Asthma Education and Prevention Program (NAEPP) and Global Initiative for Asthma (GINA) guidelines and review recent updates in clinical management
   • Understand treatment options including anti-inflammatory “controller” medications and rescue medications, including methods of medication delivery and treatment side effects
   • Recognize common asthma triggers and learn how to manage environmental factors
   • Review management of asthma exacerbations and the rationale for institutional protocols
   • Recognize different asthma phenotypes in childhood
   • Know how to evaluate sports performance and the management of exercise-induced bronchoconstriction
   • Understand how biologic therapies are included in the pathway of treatment
   • Review the current understanding of how COVID-19 infection affects asthmaRecognize the determinants of health in patients with asthma
4. Pulmonary infections
   • Pneumonia – bacterial vs viral and specific findings on CXR that may help in identification of the offending agent.
   • Bronchiolitis – viral etiology and potential association with asthma.
   • Treatment options including appropriate antibiotics for suspected bacterial pneumonia and the clinical usefulness of nebulized medications in the treatment of bronchiolitis.
   • Immunizations including influenza, RSV, and pneumococcal.
5. Congenital pulmonary conditions
   • Laryngomalacia, tracheomalacia, vascular rings, congenital cystic adenomatoid malformation (CCAM), diaphragmatic hernia, and tracheoesophageal fistula (TEF)
     • Airway Abnormalities lecture by Dr. St. Onge
     • Learn about managing a tracheostomy on this CHOP online course

6. Sleep-Related Breathing Disorders (Extended version learning) 

7. Learns and understands the application of specific pulmonary diagnostic testing including:
   • pulmonary function testing (PFT’s), oximetry, chest x-ray interpretation, and arterial blood gas interpretation
   • Chest imaging lecture by Dr. St. Onge
8. Recognizes how infection control relates to specific pulmonary diseases