General Internal Medicine

Pulmonology   

Questions discussed in this category



Joint symptoms are stable on Hydroxychloroquine. Is there benefit of adding methotrexate or Rituximab for lung disease? CT of chest with predominately...

Often distal flattening of expiratory limb or decreased Fev25-50/FVC is referred for small airway dysfunction but it is advised against using it give ...

For example, would you consider this method in an ESRD/HD patient with antiphospholipid syndrome who had a major bleed requiring reversal of warfarin ...

This question is part of our collaboration with ACR Convergence 2024 to Continue the Conversation from the meeeting. This question was inspired by the...

A patient on meloxicam for LBP developed high, persistent fevers and no other symptoms. An IGRA, among many tests, was sent. The IGRA’s mitogen ...

In patients with an average of less than 5 respiratory events per hour, adequate sleep duration and hygiene were confirmed on the sleep log, absent ca...

Do you perform it on every suspected case, or are there specific indications you look for before proceeding with BAL?

This question is part of our collaboration with ACR Convergence 2024 to Continue the Conversation from the meeeting. This question was inspi...

A patient on meloxicam for LBP developed high, persistent fevers and no other symptoms. An IGRA, among many tests, was sent. The IGRA’s mitogen ...

Pre-treatment troponin was mildly elevated, while ILR2 receptor, ACE, CRP, ESR were normal. 

If so, what dose and formulation of morphine do you prefer?The PACIFY COUGH trial utilized controlled-release morphine 5 mg BID, however the lowest do...

Do you routinely perform transbronchial biopsies in addition to BAL in all cases?

What clinical significance does this have and how do you follow these patients?

Is a biopsy or EMG helpful in confirming the etiology? What is the best treatment for sarcoid neuropathy?

In trapped lung, a fibrous peel over the visceral pleura restricts pleural expansion. Could transudative pleural effusions lead to this condition?

I've seen a handful of fatal radiation pneumonitis associated with rapid steroid tapers by the non-treating physicians. How do you recommend prescribi...

Specifically, do you check for any of these: ACE, Vitamin D 1,25, serum lysozyme, soluble IL2 or Adenosine deaminase levels?

Common thought is that FVIII may be used for differentiating coagulopathy in liver disease (normal to increased, from reduced clearance of VWF/FVIII) ...

Do you use biomarkers or PET scanning to stratify patients who may benefit most from therapy?

This question is part of a collaboration with RheumMadness and is in reference to Pathogenic ANCA (RAVE Trial).

Normally, waiting 6-12 weeks of therapeutic anticoagulation after an acute PE is suggested for any bronchoscopic procedure, however there is always a ...

The cohort in the study was predominantly white. Do these results highlight significant disparities in COPD care?

While classically described as seen in seropositive patients, have they been reported in seronegative RA?

Patients on baseline mycophenolate and azathioprine were excluded from the INBUILD trial however many patients with CTD-ILD will be on some form of im...

Do you base the decision on FEV1, 6MWD or symptoms at initial evaluation, or progression over time?

Is there a minimum standard for which stations to sample? Does lymph node size affect your recommendations?

If a patient clearly has N1 disease with high SUV on PET, do you routinely recommend EBUS or mediastinoscopy to evaluate for N2 disease?

Occasionally, supplemental oxygen may alter Fick measurements giving falsely high CO and falsely low PVR, therefore is Thermodilution method preferred...

How are your teams effectively evaluating and counseling patients to ensure they are prepared for potential extended adjuvant treatment approaches? Is...

Would you have a different opinion based on whether it is a new therapy or an existing and previously well-tolerated therapy for the patient?

Are two negative pleurocentesis' adequate to conclude that the patient does not have metastatic disease? Do you routinely recommend VATS and pleural b...

Would inhaled steroids help reduce the PO dose and/or significantly accelerate tapering?  If s, for what pneumonitis grade? What specific steroid...

How is your approach to treatment different than other ILD patterns such as NSIP? Does treatment response vary based on underlying CTD?

For example, a patient with a large (>3cm), spiculated, FDG-avid lung lesion, who has poor lung function and is refusing a CT-guided biopsy?

Should staging and treatment decisions be made based on imaging alone?

When there is biopsy proven mediastinal disease, do you offer definitive chemoradiation and monitor, or do you try to prove the presence/absence ...

The NCCN guidelines call for pathological mediastinal lymph node staging for all NSCLC except in solid tumors <1cm and non-solid lesions < ...

Following lung RT, I have rarely seen patients present with pneumonia-like symptoms of radiation pneumonitis. I'm more likely to see a patient with wo...

In practice, do you send patients with N2/3 disease for mediastinal staging if not offered upfront?


Papers discussed in this category


J Thorac Cardiovasc Surg, 2011 Mar

Semin Radiat Oncol, 2015 Oct

J. Clin. Oncol., 2008-07-20

Chest, 2007 Sep

Int. J. Radiat. Oncol. Biol. Phys., 2010-06-01

Thorac Cancer, 2017 Apr 24

Autoimmunity reviews, 2021 Apr 19

Arthritis & rheumatology (Hoboken, N.J.), 2024 Jul 08

Rheumatology international, 2023 Apr 18

Autoimmunity reviews, 2024 Sep 11

Ann. Rheum. Dis., 2018 May 03

Ann. Rheum. Dis., 2018 Apr 25

The Lancet. Respiratory medicine, 2016-09

The New England journal of medicine, 2006-06-22

Nature reviews. Rheumatology, 2018-05

Lancet Respir Med, 2020 Aug 28

Trials, 2017 Jun 15

N Engl J Med, 2019 Sep 29

N. Engl. J. Med., 2019 May 20

N Engl J Med, 2012 May 20

Annals of the rheumatic diseases, 2022 Nov 03

Frontiers in immunology, 2021 Apr 12

Arthritis Rheum,

Eur Heart J, 2015 Aug 29

Eur Respir J, 2019 Jan 24

BMJ Open, 2019 May 05

Rheumatol Int, 2021 Jan 29

Eur Respir Rev, 2021 Dec 15

Ann Am Thorac Soc,

American journal of respiratory and critical care medicine, 2010-08-01

Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG, 2002-10

Eur Respir J,

Eur Respir J,

J Intern Med,

Eur Respir J, 2021 Dec 16

N Engl J Med, 2021 Jan 13

Lancet Respir Med, 2021 Jun 29

N Engl J Med, 2022 Sep 04

The European respiratory journal, 2015-10

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2000-04

Chest, 2018 Jan 11

J Allergy Clin Immunol Pract, 2021 Mar 06

Chest, 2020 Aug 31

J Allergy Clin Immunol Pract, 2020 Jun 16

Cureus, 2020 Aug 12

J Allergy Clin Immunol Pract, 2015 Jan 29

The European respiratory journal, 2019-01

Eur Respir J, 2019 Jan 24

Chest, 2011-06

JAMA,

JAMA,

American journal of respiratory and critical care medicine, 2011-02-15

Chest, 2011-07

The Lancet. Respiratory medicine, 2017-12

J Heart Lung Transplant, 2021 Nov

ERJ Open Res, 2019 Jul 08

BMC Pulm Med, 2018 Jan 17

American journal of respiratory and critical care medicine, 2013-04-01

Am J Respir Crit Care Med,

The European respiratory journal, 2018-08

J Am Coll Cardiol,

Rheumatology (Oxford, England), 2017-06-01

Autoimmun Rev, 2012 Jul 05

Arthritis & rheumatology (Hoboken, N.J.), 2017-03

Lancet Respir Med, 2021 Jan

Am J Respir Crit Care Med,

Lancet Respir Med,

Eur Respir Rev, 2022 Apr 13

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2022 Jun 11

European respiratory review : an official journal of the European Respiratory Society, 2021 Dec 22

Eur Respir J, 2019 Apr 18

Am J Obstet Gynecol MFM, 2021 Mar 27

Respirology, 2013 Nov 29

Respir Res, 2022 Jun 21

Circulation, 2013-07-30

The European respiratory journal, 2018-02

Circulation, 2011 Jun 27

Int J Cardiol, 2019 Jan 04

Cochrane Database Syst Rev, 2019 Jan 31

Chest, 2014 Nov

Circulation, 2021 Feb 08

N Engl J Med, 2021 Aug 27

ERJ Open Res, 2022 Feb 21

European journal of internal medicine, 2023 Sep 04

J Infect Dis, 2020 Jun 11

Clin Chest Med, 2013 Apr 08

Hepatology, 1996 Jun

Hepatology, 1986 Jul-Aug

Gut, 1992 Jan

Chest, 2016-03

Chest, 2008 Feb 08

JAMA, 2010 Nov 24

Eur Respir J, 2017 Sep 09

Thorax, 2019 Jan

Clin Med Insights Circ Respir Pulm Med, 2021 Mar 30

Cureus, 2022 Sep 06

Respir Res, 2023 Jan 9

J Thromb Haemost, 2021 Jul 14

Blood, 2020 Mar 19

Ann Am Thorac Soc, 2017 May

Journal of clinical medicine, 2020 Dec 23

Chest, 2023 Feb 17

The New England journal of medicine, 2014 Oct 01

Circulation, 2015 Sep 15

The Annals of thoracic surgery, 2017 Feb 04

European heart journal, 2023 Oct 14

Arthritis & rheumatology (Hoboken, N.J.), 2015-05

International journal of rheumatic diseases, 2014-02

Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG, 2014-04-18

Clinical nuclear medicine, 2016-05

J Investig Med High Impact Case Rep, 2021 Jan-Dec

Clinical therapeutics, 2018 Feb

Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG, 2014-04-18

Heart rhythm, 2014-07

Circulation journal : official journal of the Japanese Circulation Society, 2019 Oct 09

Rheumatology (Oxford, England), 2011 Dec 30

Arrhythmia & electrophysiology review, 2020 Dec

Arthritis Rheumatol, 2021 Jul

Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis, 2021 Nov 12

Radiographics : a review publication of the Radiological Society of North America, Inc, 2013 Nov-Dec

British journal of haematology, 2024 Sep 02

European respiratory review : an official journal of the European Respiratory Society, 2021 Nov 08

Circulation, 2023 Mar 16

JAMA neurology, 2018-12-01

Journal of neuroimmunology, 2022 Apr 09

International journal of radiation oncology, biology, physics, 2023 Mar 07

The European respiratory journal, 2023 Feb 09

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2017 Nov 15

Expert review of respiratory medicine, 2023 Jun 23

JAMA network open, 2023 Aug 01

Blood, 2013 Jun 04

Annals of internal medicine, 2021 Nov 23

AJR Am J Roentgenol,

Current opinion in pulmonary medicine, 2013 Sep

Annals of the rheumatic diseases, 2024 Jan 11

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2012-08

Current medical research and opinion, 2016-12

Lancet (London, England), 2011-05-21

The New England journal of medicine, 2018 Aug 26

Respiratory research, 2021 Apr 26

The New England journal of medicine, 2014 May 18

Respiratory investigation, 2020 Sep 03

Advances in therapy, 2023 Mar 16

American journal of respiratory and critical care medicine, 2011-10-01

American journal of respiratory and critical care medicine, 2019 Jul 15

American journal of respiratory and critical care medicine, 2023 Jan 01

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2015-05

J Immunother Cancer, 2021 Jul

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2016 Jul 07

Arthritis & rheumatology (Hoboken, N.J.), 2019 Oct 21

European journal of cancer (Oxford, England : 1990), 2023 Dec 28

Arthritis and rheumatism, 2006 Mar

Sleep, 2007-06

Current opinion in pulmonary medicine, 2023 Jun 30

Rheumatology (Oxford, England), 2023 Feb 01

International journal of cardiology. Heart & vasculature, 2021 Apr 29

The European respiratory journal, 2005-11

The European respiratory journal, 2022 Jul 13

PloS one, 2024 Jun 13

JAMA otolaryngology-- head & neck surgery, 2020 Jan 01

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2024 Mar 14

Neurology, 2001-07-24

The European respiratory journal, 2019-06

Chest, 2017-03

ERJ open research, 2017-07

Chest, 2023 Dec 19

The European respiratory journal, 2023 Nov 29

The European respiratory journal, 2014 Aug 07

Journal of clinical medicine, 2024 Jan 07

Rheumatology (Oxford),

Rheumatology (Oxford, England), 2023 Dec 01

Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG, 2004-03

Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG, 2000-03

Chest, 2003-07

American journal of respiratory and critical care medicine, 2006-10-01

Diagnostics (Basel, Switzerland), 2024 Jan 23

Chest, 1999 Aug

Respiration; international review of thoracic diseases, 2012 Dec 29

The Lancet. Respiratory medicine, 2024 Jan 15

NEJM evidence, 2023 May 22

Chest, 2005-01

American journal of respiratory and critical care medicine, 2002 Jan 15

Clinics in chest medicine, 2004 Dec

N Engl J Med, 2020 Feb 13

N Engl J Med, 2021 Feb 18

The European respiratory journal, 2020 Aug 06

American journal of respiratory and critical care medicine, 2020 Aug 01

American journal of respiratory and critical care medicine, 2019-11-01

The European respiratory journal, 2021 Mar 04

Rheumatology (Oxford, England), 2020 Dec 01

Journal of asthma and allergy, 2019

Chest, 2020 Sep 01

The European respiratory journal, 2009 Mar 26

American journal of respiratory and critical care medicine, 2013-09-15

Journal of thoracic disease, 2024 Jan 11