PulmPEEPs

Dr. Emily Fridenmaker, a Pulmonary, Critical Care, and Sleep Medicine fellow, joins the hosts to analyze a complex case of a middle-aged woman with fevers, night sweats, and dyspnea. They discuss the importance of thorough patient history, differential diagnoses including infections and malignancies, and the management of such cases. The chapter also explores histoplasmosis, its symptoms, diagnosis, and treatment options.

Experts discuss strategies in diagnosing interstitial lung disease, emphasizing history-taking, imaging protocols, bronchoscopy, and genetic evaluations. They highlight the importance of prompt results, multidisciplinary discussions, and engagement opportunities with the American Thoracic Society for trainees and junior faculty.

Pulmonary experts Dave Furfaro, Kristina Montemayor, and Ansa Razzaq discuss a case of dyspnea and lymphadenopathy, exploring diagnostic challenges, radiological findings, sarcoidosis diagnosis complexities, and treatment options beyond steroids for pulmonary conditions.

Expert Sandy Zaeh discusses the assessment and management of severe asthma exacerbations. Topics include evaluating clinical severity, understanding Pulsus paradoxus, obtaining a comprehensive patient history, medication dosages, intubation challenges, and managing auto PEEP on the ventilator.

Experts in critical care medicine and ARDS, including Roy Brower, discuss the role of PEEP in ARDS patients. They cover topics like lung protective ventilation, personalized ventilator strategies, driving pressure optimization, and bedside care in the ICU.

Natalie West, a pulmonology specialist, discusses a complex case of a 50-year-old woman with chronic cough. They explore differential diagnoses, bronchiectasis, cystic fibrosis testing, and the importance of comprehensive care for patients with chronic respiratory symptoms.

Experts discuss managing hemoptysis, assessing clinical stability, source of bleeding, airway protection, use of tranexamic acid, and practical tips for handling hemoptysis cases in a Top Consults series on pulmonary and critical care consults.

Ansa Razzaq, Pulm PEEPs senior editor, discusses a challenging case of worsening episodic dyspnea in a woman with well-managed asthma, eventually diagnosed with Allergic Bronchopulmonary Aspergillosis. The podcast covers topics such as spirometry interpretation, managing difficult-to-treat asthma cases, advanced testing for allergic phenotype, and bronchiectasis with ABPA diagnosis and treatment.

The Pulm PEEPs (Kristina Montemayor and Dave Furfaro) host a panel of Cystic Fibrosis (CF) providers to discuss the current state of the disease, recent advances in cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies, and the evolving faces and voices of Cystic Fibrosis. Cystic Fibrosis is an autosomal recessive disorder caused by mutations in the CFTR gene that affects over 30,000 individuals in the United States and 70,000 people worldwide. Absence or dysfunction of the CFTR protein leads to abnormal secretion of mucus, sweat, and digestive fluids, which impacts the lungs, digestive tract, and reproductive system. From the first formal publication on Cystic Fibrosis in 1938 by Dorothy Hansine Andersen, to the discovery of the delta F508 mutation and CFTR gene in 1988 -1989 by Lap-Chee Tsui, Francis Collins, and John R. Riordan, to the approval of the first CFTR modulator therapy, Ivacaftor, in 2012, our knowledge about Cystic FIbrosis has been advancing in leaps and bounds. As therapies have improved, they have dramatically impacted the lives of patients with Cystic Fibrosis. Join us today as we explore what this evolution in care has looked like from the perspective of Cystic Fibrosis providers, and hear about the new questions and challenges on the horizon. Meet our guests Emily DiMango is a Professor of Medicine at Columbia University Medical Center and the Director of the John Edsall-John Wood Asthma Center and the Gunnar Esiason Adult Cystic Fibrosis Program Terri Laguna is an Associate Professor of Pediatrics at Northwestern Medicine / Feinberg School of Medicine and the Chief of Pulmonary and Sleep Medicine in the Department of Pediatrics Patrick Sosnay is a Senior Medical Director at Vertex Pharmaceuticals and specializes in Cystic Fibrosis Natalie West is an Assistant Professor of Medicine at Johns Hopkins Hospital and specializes in Cystic Fibrosis. References and links for further reading Cystic Fibrosis FoundationShteinberg M, Haq IJ, Polineni D, Davies JC. Cystic fibrosis. The Lancet. 2021;397(10290):2195-2211. doi:10.1016/S0140-6736(20)32542-3Rowe SM, Miller S, Sorscher EJ. Cystic Fibrosis. New England Journal of Medicine. 2005;352(19):1992-2001. doi:10.1056/NEJMra043184Davis PB. Cystic Fibrosis Since 1938. Am J Respir Crit Care Med. 2006;173(5):475-482. doi:10.1164/rccm.200505-840OEBarry PJ, Mall MA, Álvarez A, et al. Triple Therapy for Cystic Fibrosis Phe508del–Gating and –Residual Function Genotypes. New England Journal of Medicine. 2021;385(9):815-825. doi:10.1056/NEJMoa2100665Middleton PG, Mall MA, Dřevínek P, et al. Elexacaftor–Tezacaftor–Ivacaftor for Cystic Fibrosis with a Single Phe508del Allele. New England Journal of Medicine. Published online October 31, 2019. doi:10.1056/NEJMoa1908639

We are excited to introduce Pulm PEEPs to the world! Our mission is to provide learners of all levels with multiple formats to engage in pulmonary and critical care education that you can access anytime. In addition to podcast episodes, we will be sharing helpful infographics and guides to shed light on topics throughout pulmonary and critical care from the bread-and-butter to the esoteric and complex. We will be gathering insights from world experts in the hope to share their knowledge and make it accessible for all. This is only the beginning and please join us each step of the way! In this introductory episdoe you get to meet the PEEPs! Kristina “Monty” Montemayor and Dave “Furf” Furfaro are the Co-Founders of Pulm PEEPs. They first met during residency at Johns Hopkins and share a love for medical education and all topics pulmonary and critical care related. Ansa Razzaq is a Chief Resident in the internal medicine residency at New York-Presbyterian Hospital / Columbia University. She is interested in medical education and pulmonary and critical care medicine. She’ll be bringing amazing cases and helping us work through them from presentation to treatment.