{"id":681,"date":"2015-09-30T18:12:28","date_gmt":"2015-09-30T18:12:28","guid":{"rendered":"http:\/\/hfhpulm.com\/info\/?p=681"},"modified":"2020-08-27T13:36:31","modified_gmt":"2020-08-27T13:36:31","slug":"interstitial-lung-diseases","status":"publish","type":"page","link":"http:\/\/hfhpulm.com\/info\/?page_id=681","title":{"rendered":"Interstitial Lung Diseases"},"content":{"rendered":"\n

Curriculum<\/a><\/p>\n\n\n

Learning Objectives:<\/p>\n

\u00a0<\/p>\n

    \n
  1. Approach to the patient with diffuse parenchymal lung disease\n
      \n
    1. Key historical points (symptoms on presentation, exposures, screening for systemic illness, R heart failure)<\/li>\n
    2. Differential of dyspnea<\/li>\n
    3. Who needs biopsy?<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n
        \n
      1. Transbronchial vs. surgical lung biopsy<\/li>\n
      2. Algorithm for referral for biopsy in UIP<\/li>\n
      3. Lymphangioleimyomatosus \u2013 epidemiology, presentations, treatment<\/li>\n
      4. Pulmonary Langerhans Cell Histiocytosis<\/li>\n<\/ol>\n
          \n
        1. Idiopathic Interstitial Pneumonia\n
            \n
          1. Differential based on radiographic pattern (subpleural predominance, peribronchovascular distribution, ground glass, mosaic attenuation, cyst formation, nodules, honeycombing, and reticular patterns)<\/li>\n
          2. Epidemiology, classic clinical presentation, classic radiograph patterns and pathologic differences of the 7 IIPs<\/li>\n
          3. Idiopathic Pulmonary Fibrosis \u2013 diagnostic algorithm, followup, prognostic indicators, comorbidities<\/li>\n
          4. Treatment options for IIPs (and failed ones for IPF)<\/li>\n
          5. Mechanisms and potential complications of immunosuppressive agents<\/li>\n
          6. Indications for referral and listing for lung transplant<\/li>\n<\/ol>\n<\/li>\n
          7. Other entities\n
              \n
            1. Hypersensitivity pneumonitis \u2013 epidemiology, common exposures, acute -> chronic differences in presentation and radiographs, typical pathology<\/li>\n
            2. Drug-induced ILD \u2013 common culprits and presentations<\/li>\n
            3. Cystic<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n
                \n
              1. Pulmonary manifestations of systemic disease\n
                  \n
                1. Systemic Lupus Erythematosus<\/li>\n
                2. Rheumatoid Arthritis<\/li>\n
                3. Systemic sclerosis – review treatment trials, how staging of ILD relates to prognosis<\/li>\n
                4. Dermatomysositis\/polymyositis<\/li>\n
                5. Other: IBD, ankylosing spondylitis, etc<\/li>\n<\/ol>\n<\/li>\n
                6. Vasculitis\n
                    \n
                  1. Specific entities (Necrotizing Granulomatous polyangitis, Churg Strauss, Microscopic polyangitis, Goodpasture\u2019s) \u2013 epidemiology, classic presentations, natural history<\/li>\n
                  2. When should vasculitis be included in the differential?<\/li>\n
                  3. Workup, treatment (remission and maintenance), followup indicators<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n

                    \u00a0<\/p>\n

                    Expectations of the Fellow:<\/p>\n

                      \n
                    • Volume: 1-2 new consults per clinic, 1-2 followups (based on clinic volume, complexity of patients)<\/li>\n
                    • Preparation prior to clinic \u2013 chart review when available, basic knowledge of followup disease entity (epidemiology, typical treatment, natural history)<\/li>\n
                    • Workup of new patients: Adequate history (including exposure history, screening for systemic illness), summary of prior workup\/films if pertinent, identify major radiographic pattern and its differential, initial plan of diagnostic workup\/treatment (if applicable)<\/li>\n
                    • Followup patients: Identify the key issues in monitoring of progresss, immunosuppressive course, complications<\/li>\n
                    • Presentations: 2 during a 2 week period\n
                        \n
                      1. Article review pertinent to a patient seen (ex intervention trial in vasculitis on maintenance therapy)<\/li>\n
                      2. Overview of an entity not seen (2nd<\/sup> week) \u2013 review of epidemiology, natural history, presentation<\/li>\n<\/ol>\n<\/li>\n<\/ul>\n

                        \u00a0<\/p>\n

                        Reading List<\/strong><\/p>\n

                        Articles are available on the pulmonary server<\/p>\n

                        \u00a0<\/p>\n

                          \n
                        • Diagnosis (including path review)<\/li>\n
                        • Idiopathic Interstitial Pneumonia\n
                            \n
                          1. Idiopathic Pulmonary Fibrosis<\/li>\n
                          2. Other<\/li>\n<\/ol>\n<\/li>\n
                          3. Connective tissue disease<\/li>\n
                          4. Immunosuppression<\/li>\n
                          5. Vasculitis<\/li>\n
                          6. Drug-induced<\/li>\n
                          7. Hypersensitivity pneumonitis<\/li>\n
                          8. Other entities<\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"

                            Curriculum Learning Objectives:   Approach to the patient with diffuse parenchymal lung disease Key historical points (symptoms on presentation, exposures, screening for systemic illness, R heart failure) Differential of dyspnea Who needs biopsy? Transbronchial vs. surgical lung biopsy Algorithm for referral for biopsy in UIP Lymphangioleimyomatosus – epidemiology, presentations, treatment Pulmonary Langerhans Cell Histiocytosis Idiopathic […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-681","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"http:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/pages\/681","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=681"}],"version-history":[{"count":3,"href":"http:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/pages\/681\/revisions"}],"predecessor-version":[{"id":2883,"href":"http:\/\/hfhpulm.com\/info\/index.php?rest_route=\/wp\/v2\/pages\/681\/revisions\/2883"}],"wp:attachment":[{"href":"http:\/\/hfhpulm.com\/info\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=681"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}