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Pulmonology   

Questions discussed in this category

Do you perform routine interval lung cancer screening in non-smokers who are 1st degree relatives of patients with non-smoking related lung cancers with known EGFR mutations?
3 Answers available
Would you consider deferring chest tube placement in a clinically stable patient with a small empyema without signs of systemic infection?
2 Answers available
How do you approach medication management in biopsy-proven pulmonary sarcoidosis with disease stable for over 2 years on hydroxychloroquine and low dose prednisone?
Do you discontinue HCQ?
2 Answers available
Is a larger bore percutaneous chest tube sufficient to adequately drain a hemothorax, or is a surgical chest tube required?
1 Answer available
Is there a subset of ANCA vasculitis patients for which you would try plasma exchange?
2 Answers available
For how long do you recommend treatment for latent tuberculosis prior to initiation of anti-TNF therapy?
6 Answers available
Do you utilize phrenic nerve EMG in patients with diaphragmatic issues?
1 Answer available
What is your blood pressure or mean arterial pressure goal in a critically ill patient with acute kidney injury?
1 Answer available
What is your approach to the evaluation and management of a suspected intrapulmonary hematoma?
1 Answer available
What agents do you utilize for mucociliary clearance during the index hospitalization of patients post lung transplant?
1 Answer available
What is your approach to the use of Paxlovid for patients with risk factors for severe Covid-19 infection but who have received SARS-CoV-2 vaccines in light of the EPIC-SR trial findings?
EPIC-SR Trial
2 Answers available
What serologic biomarkers do you send to assess for sarcoidosis at baseline and/or during flares, in patients where it may correlate with disease activity?
Specifically, do you check for any of these: ACE, Vitamin D 1,25, serum lysozyme, soluble IL2 or Adenosine deaminase levels?
1 Answer available
Do you use intrapleural tPA/dornase in loculated effusions that are not due to infection?
1 Answer available
What blood pressure targets do you enforce in the first 24-48 hours in a patient who develops an intracranial hemorrhage after mechanical thrombectomy?
Blood pressure targets for ischemic stroke and intracerebral hemorrhage are described in several guidelines. However, in patients with acute stroke wh...
2 Answers available
How small of a nodule would you attempt to biopsy with robotic bronchoscopy?
1 Answer available
Is methacholine challenge on its way out?
1 Answer available
How do you assess the use of Heimlich valves for patients who present with persistent air leaks?
1 Answer available
How do you approach management of adult patients with CVID and sarcoid-like syndrome?
1 Answer available
What is your preferred first-line treatment for chronic fatigue in patients with long COVID-19?
5 Answers available
How do you manage patients with central sleep apnea due to heart failure with reduced ejection fraction?
Are there specific scenarios in which you employ BPAP with a back up rate?
1 Answer available
Are there patients with granulomatosis with polyangiitis on maintenance rituximab therapy for whom you do not co-administer glucocorticoid therapy?
2 Answers available
Do you routinely perform genetic testing in patients presenting with pulmonary fibrosis who endorse a family history of fibrotic lung disease?
1 Answer available
Would you stop azathioprine in a patient with ANCA vasculitis who has been in long term remission on azathioprine, but has a new diagnosis of lung cancer requiring initiation of immunotherapy?
2 Answers available
What are your top takeaways from ISHLT 2024?
1 Answer available
Do you ever consider close clinical monitoring over antifibrotic therapy in patients ascribed an MDD diagnosis of IPF who have normal lung function and are asymptomatic?
2 Answers available
Has your management of severe hyponatremia changed after a recent observational study described higher in-hospital mortality for sodium correction of <6 mEq/L compared to 6-10 mEq/L in the first 24 hours?
Seethapathy et al., NEJM
5 Answers available
How do you manage concurrent nonlife-threatening hemoptysis and acute pulmonary embolism?
Estimating blood loss from hemoptysis is not always reliable. The bleeding may be due to the PE itself. Is anticoagulation with any degree of hemoptys...
1 Answer available
Do you extend the duration of maintenance therapy past 24 months for patients with ANCA glomerulonephritis who have multiple organ involvement?
2 Answers available
For patients with suspected complement-mediated TMA, are there specific clinical or laboratory parameters that can help guide the decision for starting empirical treatment (e.g., eculizumab) while awaiting the results of complement testing?
1 Answer available
Do you utilize robotic bronchoscopy to biopsy a lung cavity wall?
1 Answer available
How do you manage diarrhea in a patient with CTD-ILD on MMF who was recently started on full dose nintedanib?
5 Answers available
Is there a role for repeat surveillance blood cultures in patients with prosthetic valve endocarditis without associated cardiac abscess after a 6 week course of antibiotic treatment without surgical intervention?
1 Answer available
How would you manage a patient with morbid obesity who presents with new symptomatic pulmonary embolism a few days after he was started on DOAC for DVT?
What is your preferred anticoagulation in patients with BMI >50?
4 Answers available
Do you diagnose obstruction by the criteria of FEV1/FVC < 70% or < LLN?
5 Answers available
When do you consider the use of PH specific therapies in patients with pre-capillary pulmonary hypertension associated with sickle cell disease?
2 Answers available
Do you treat A0B1 rejection noted on surveillance bronchoscopy in a patient less than one year post lung transplant?
1 Answer available
Is there a role for chronic suppressive oral or inhaled therapy for recurrent Burkholderia cepacia pneumonia causing frequent hospitalizations in a patient with severe bronchiectasis with or without underlying cystic fibrosis?
3 Answers available
Do you use acetazolamide to aid diuresis in patients with acute on chronic respiratory acidosis with significantly elevated serum bicarbonate levels?
3 Answers available
In what clinical scenarios do you utilize post-cardiac arrest targeted temperature management (TTM)?
In the span between the HACA trial and the Targeted Temperature Management in Out-of-Hospital Cardiac Arrest study (Dankiewicz et al., PMID 34133859),...
1 Answer available
Do you use hypercapnia as an exclusion criteria in all patients that are being assessed for bronchoscopic lung volume reduction?
1 Answer available
How do you follow pulmonary embolism patients who have completed anticoagulation?
1 Answer available
Is there a role for nintedanib in the management of patients with radiation-induced pulmonary fibrosis?
1 Answer available
What approaches can we take to initiate therapy and improve survival rates in patients with HLH?
1 Answer available
Do you use any drugs prophylactically to reduce the risk of radiation pneumonitis in lung SBRT?
Would you provide pentoxyphylline and vitamin E prophylactically after treatment? Is there a role for Boswellia? ACE inhibitor?
1 Answer available
Do you routinely use 3% sodium chloride and desmopressin to correct hypovolemic hyponatremia in an asymptomatic patient with serum sodium of less than 120 mEq/L?
3 Answers available
Are you using genomic classifiers to diagnose UIP when imaging is indeterminate or suggestive of an alternate diagnosis?
3 Answers available
Do you favor timely bronchoscopy for diagnostics over close surveillance in mildly symptomatic patients with CT findings suspicious for NTM infection who are not able to expectorate?
3 Answers available
What protective post-op measures do you recommend for a patient with scleroderma and a history of ILD, PH, Raynaud’s and digital ischemia undergoing cardiothoracic surgery?
1 Answer available
In patients being evaluated for brain death, which abnormal movements are definitively known to still be consistent with brain death and which are possibly consistent with brain death but lack definitive evidence?
What are the sources for this and are they reliable by today’s standards? Numerous case series report various abnormal movements but how reliabl...
1 Answer available
How are you navigating approval of CPAP for patients with a high suspicion for OSA on chronic oxygen who are unable to complete an in-lab PSG?
2 Answers available
How do you navigate PAP approval for patients with tracheobronchomalacia or excessive dynamic airway collapse who do not have OSA?
1 Answer available
Do you consider skin involvement associated with tattoos to be a marker of disease activity and an indication to start treatment in a patient with sarcoidosis?
1 Answer available
What is your approach to the use of acetazolamide in patients with OSA?
1 Answer available
Do you grade severity of OSA by AHI or RDI?
2 Answers available
Would you start any treatment for radiation pneumonitis if there is a large area of consolidation in the irradiated lung field but the patient is asymptomatic?
Would you consider pentoxifylline and vitamin E to mitigate fibrosis?
2 Answers available
Should checking a urinalysis with reflex to culture be part of the standard work up for fever in an ICU patient with a urinary catheter?
2 Answers available
Do you obtain an echocardiogram as a part of risk stratification in all patients hospitalized with an acute pulmonary embolism?
2 Answers available
Is there a role for biologics to improve lung function in patients who have severe asthma with daily symptoms and reduced lung function but do not experience frequent exacerbations?
1 Answer available
How do you approach biologic initiation in patients with inflammatory arthritis and repeatedly indeterminate Quantiferon?
5 Answers available
How do you approach patients with RA and severe bronchiectasis with associated findings of UIP?
1 Answer available
How do you determine if pulmonary hypertension is disproportionate to the severity of lung disease?
2 Answers available
Is there a role for nocturnal supplemental oxygen as opposed to no therapy in patients with OSA who are unable to tolerate PAP therapy?
1 Answer available
Do you use absolute random cortisol levels or delta cortisol levels after ACTH stimulation to diagnose adrenal insufficiency in the critically ill?
2 Answers available
How do you approach treating and monitoring sarcoidosis manifested by maxillary bone/teeth loss without other symptoms?
3 Answers available
When do you pursue interventional treatments in a lung transplant patient with anastomotic dehiscence complicated by a bronchopleural fistula?
1 Answer available
What else do you consider in the differential diagnosis for pulmonary-renal syndromes if there is low clinical and serologic evidence of AAV, Goodpasture's or other rheumatologic disease (SLE, RA, APS, Scleroderma)?
2 Answers available
When do you consider the use of steroids in the management of acute exacerbations in patients with cystic fibrosis?
1 Answer available
How do you workup patients with neuropathy suspected to be secondary to sarcoid?
Is a biopsy or EMG helpful in confirming the etiology? What is the best treatment for sarcoid neuropathy?
1 Answer available
What is your approach to the management of persistent hydropneumothorax due to a non expandable lung?
1 Answer available
What patient factors, if any, would lead you to extubate a patient at high risk of extubation failure to AVAPS rather than BIPAP?
1 Answer available
How do you define severe hypoxic burden on home sleep testing?
1 Answer available
Do you consider tracheostomy for the management of continued hypercapnea despite compliance with PAP in patients with OHS and OSA?
2 Answers available
What factors do you consider while selecting high risk patients for prophylactic NIV after planned extubation?
1 Answer available
Do you use steroids in the management of PJP pneumonia with severe hypoxia in HIV negative patients?
Data on the role of steroids in HIV negative patients with PJP has been conflicting.
1 Answer available
What is your approach to inhaler therapy in a patient with asthma who cannot be on an inhaled corticosteroid due to ocular disease?
1 Answer available
In light of the RECITAL study, would rituximab be a reasonable choice in a patient with PL-12 antibodies, rapidly progressive pulmonary disease with organizing pneumonia on biopsy?
Given poor pulmonary outcomes in people with anti-PL12 antibodies, would you recommend more aggressive therapy? The patient was diagnosed with onset o...
1 Answer available
How are you approaching patients with early-stage NSCLC who progress on neoadjuvant chemo-immunotherapy and are no longer surgical candidates?
5 Answers available
What is your preferred mechanism for venting the left ventricle in patients on VA-ECMO?
2 Answers available
Would you restart sirolimus for a decline in lung function or pneumothoraces in a pregnant patient with LAM?
1 Answer available
How do you risk stratify patients with different WHO groups of pulmonary hypertension prior to non-cardiac surgeries?
And who would you not recommend to undergo surgeries?
1 Answer available
What would be your second pressor of choice if patients with LVOT obstruction remain persistently hypotensive on phenylephrine?
1 Answer available
How would you approach a pulmonary-renal PR3+ ANCA vasculitis patient who has persistent re-narrowing of mainstem bronchus after several dilatation and stenting procedures, with other anca features well-controlled on rituximab & avacopan?
5 Answers available
How would you manage asymptomatic osseous sarcoidosis of the lumbar spine without any other systemic involvement?
Would you use with DMARDs/biologics or monitor?
1 Answer available
Do you use FVIII levels to differentiate between DIC and coagulopathy of liver disease?
Common thought is that FVIII may be used for differentiating coagulopathy in liver disease (normal to increased, from reduced clearance of VWF/FVIII) ...
4 Answers available
Is there an age at which you consider not starting antifibrotic therapy in a patient with IPF?
1 Answer available
Do you perform PEEP titration while patients are proned?
1 Answer available
What is your approach for disease activity monitoring in patients with sarcoidosis?
1 Answer available
Do you consider immunosuppressive agents in progressive interstitial pneumonias or pneumonitis without a clear driving etiology?
1 Answer available
Do you add fludrocortisone to hydrocortisone when starting stress dose steroids in a patient with septic shock?
Though there is data to support using both hydrocortisone and fludrocortisone, it seems to be used rarely in clinical practice. A review publishe...
1 Answer available
Do you consider pulmonary hypertension related to sarcoidosis to be an indication to start steroids?
Do you use biomarkers or PET scanning to stratify patients who may benefit most from therapy?
1 Answer available
How would you approach medication de-escalation in a patient with a history of rapidly progressive CTD-ILD who responded to and is currently on mycophenolate 3 grams daily and IVIG 2mg/kg monthly infusions and has been stable for two years?
2 Answers available
Does your approach to extubating obese patients differ from your approach in non-obese patients?
1 Answer available
How do you approach management of a patient with Sjogren's disease and lung mass biopsy revealing amyloidosis?
1 Answer available
Do you routinely use vasopressin in the management of RV failure leading to shock state in the absence of an obvious treatable cause such as infarction or PE?
2 Answers available
When attempting PEEP titration, how long do you wait after decrements or increments to assess for a change in driving pressure?
1 Answer available
How do you approach management of a patient with idiopathic PAH and +ANA, but no other current symptoms/signs of active rheumatologic disease?
3 Answers available
Is there a role for monitoring serum ANCAs to assess ANCA associated vasculitis disease activity?
This question is part of a collaboration with RheumMadness and is in reference to Pathogenic ANCA (RAVE Trial).
2 Answers available
Is it safe to combine mycophenolate and adalimumab for management of pulmonary sarcoidosis in a patient that could not tolerate methotrexate?
3 Answers available
When should SBRT be preferred in operative patients who cannot undergo a lobectomy?
In other words, if offered wedge or segmentectomy, should SBRT be preferred? Does size matter ie if the lesion is < 3 vs < 2 vs < 1 cm? Does ...
2 Answers available
What is your approach to the management of symptomatic Cystic Fibrosis carriers?
1 Answer available
How long post operatively do you wait before transitioning from parenteral anticoagulation to oral anticoagulants after pulmonary thromboendarterectomy for CTEPH?
2 Answers available
What is your approach to monitoring patients with cardiac sarcoid while tapering immunosuppression?
Do you obtain serial cardiac PET scans?
1 Answer available
What is your preferred strategy for controlling bleeding after transbronchial or endobronchial biopsies?
1 Answer available
How do you manage immunosuppressive medications in patients who develop a pneumonia?
1 Answer available
What therapies do you routinely use to prevent mucus plug formation after endobronchial stent placement?
1 Answer available
Do you administer calcium to patients with K > 6.5 without EKG changes?
1 Answer available
What is your threshold to start triple therapy in mild to moderate asthma/COPD overlap with minimal functional limitation?
1 Answer available
Is dyspnea without radiation pneumonitis a side effect of lung radiation?
Is this acute or long-term, and does it matter whether this is SBRT vs fractionated?
4 Answers available
Do you prefer using end-expiratory or mean pulmonary artery wedge pressure obtained during diagnostic right heart catheterization for the classification of precapillary vs postcapillary PH?
1 Answer available
What is your approach to steroid sparing therapy in patients with suspected CTD-ILD?
2 Answers available
How long do you normally wait before considering any bronchoscopic procedure (EBUS-TBNA, Transbronchial biopsy) after an episode of acute PE in a patient needing these procedures?
Normally, waiting 6-12 weeks of therapeutic anticoagulation after an acute PE is suggested for any bronchoscopic procedure, however there is always a ...
1 Answer available
What are your top takeaways from CHEST 2023?
2 Answers available
What are best practices in management of severe acute infusion reaction from infliximab?
Patient became acutely flushed, developed severe and prolonged hypotension with brief loss of consciousness, dizziness, nausea, dry heaves and headach...
1 Answer available
In a patient with severe hyponatremia and acute kidney injury in the setting of hypovolemic shock, would fluid resuscitation take precedence over the rate at which sodium is corrected?
2 Answers available
How does the presence of interstitial lung disease affect your decision to offer SBRT for early stage NSCLC?
Specifically in O2-dependent patients? Have any dose/fractionation regimens been shown to reduce the risk of pneumonitis in this population?
6 Answers available
What is your approach to a patient who has a cardiac PET scan suggestive of sarcoid but no other supporting evidence of a diagnosis of sarcoid?
Do you typically push for myocardial biopsy in this case? 
1 Answer available
What patient factors prompt you to consider starting dupilumab in patients with COPD?
Does active smoking status influence this decision?
2 Answers available
Did the low rate of COPD exacerbations in the BOREAS cohort overall confound the results of the study?
2 Answers available
Are the results of the BOREAS trial generalizable to non-white populations?
The cohort in the study was predominantly white. Do these results highlight significant disparities in COPD care?
2 Answers available
Will you use FeNO testing in all COPD patients to determine whether they are candidates for therapy with dupilumab?
If so, would this be a consideration in all patients regardless of active smoking status? FeNO in active smokers has been questioned, could this have ...
2 Answers available
Would you give T-DXd to patients with resolved drug-induced ILD from other agents such as prior chemo/targeted therapy/immunotherapy?
2 Answers available
What is your approach in differentiating IPAF (interstitial pneumonia with autoimmune features) versus "CTD ILD" in patients with serologic abnormalities but do not fulfill criteria for autoimmune disease?
1 Answer available
How long do you continue surveillance with imaging and sputum cultures in a patient with NTM with no indications for treatment?
3 Answers available
Have you seen rheumatoid nodules or RA-ILD in patients with seronegative RA?
While classically described as seen in seropositive patients, have they been reported in seronegative RA?
2 Answers available
What is the risk of ILD recurrence in MDA5/Ro52 positive dermatomyositis following a lung transplantation?
2 Answers available
When do you entertain a diagnosis of HLA-negative antibody mediated rejection in lung transplant recipients?
1 Answer available
How would you manage a patient with radiation pneumonitis who remains symptomatic on steroids?
2 Answers available
When do you consider the use of corticosteroids in patients diagnosed with EVALI?
1 Answer available
What is your approach to volume resuscitation in patients with obvious septic shock but also with a component of suspected cardiogenic shock?
4 Answers available
Do you increase sedation or consider the use of neuromuscular blockade to prevent potential self-induced lung injury in patients with high respiratory drive?
2 Answers available
What is your approach to initial work up for a young patient with bronchiectasis?
2 Answers available
Do you ever initiate pirfenidone in patients with CTD-ILD?
1 Answer available
Do you prescribe bronchodilators to patients with radiographic emphysema and respiratory symptoms, but no spirometric obstruction?
1 Answer available
Are there preferred home exercise programs for patients without access to pulmonary rehabilitation?
1 Answer available
What is your initial treatment of choice in patients with RA and associated interstitial lung disease?
1 Answer available
Do you attempt more aggressive PEEP titration to improve the P/F ratio prior to proceeding with proning in patients with ARDS and P/F <150?
1 Answer available
Do you discontinue proning due to a perceived lack of response to intervention in a patient with ARDS?
2 Answers available
What is your approach to the management of a patient with idiopathic pneumonia syndrome following stem cell transplant who does not demonstrate clinical improvement with steroid therapy?
1 Answer available
How do you manage GI side effects related to CFTR modulator therapy?
2 Answers available
Is there a role for biologics to help patients with ABPA who are steroid responsive and have removed their allergen insult, but continue to have an elevated serum IgE and incomplete resolution of symptoms return to their baseline functional status?
1 Answer available
Do you consider dual biologic therapy in patients with ABPA that remain steroid dependent despite the use of omalizumab?
2 Answers available
How do you approach the use of chronic azithromycin in patients with CF who may require therapy with IV tobramycin in the future?
Given the suggestion of the antagonistic effect of azithromycin on IV tobramycin in prior studies.
1 Answer available
When do you screen for pulmonary hypertension in ILD patients?
1 Answer available
What strategies do you employ to prevent post-intubation hypotension in a profoundly hypoxic patient given a paralytic for intubation?
1 Answer available
What strategies do you employ to minimize the risk of cardiovascular collapse when intubating a patient with severe pulmonary hypertension?
Do you favor awake intubation in these cases?
2 Answers available
Do you recommend transfer to an institution with a PE response team for a patient with an intermediate risk PE?
1 Answer available
Is there a role for the use of biologics as steroid sparing agents in treating patients with ABPA who are intolerant to prednisone?
1 Answer available
What is your approach to using nintedanib in patients on baseline immunosuppression?
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...
5 Answers available
What is your preferred steroid sparing agent in the treatment of Sjögren associated LIP?
2 Answers available
What is your approach towards management of symptomatic broncholithiasis?
What factors do you consider while deciding between bronchoscopic vs surgical management?
1 Answer available
Do you use continuous or intermittent bronchodilator therapy in severe airway obstruction?
1 Answer available
Would you place an IVC filter in a patient with an acute intermediate risk PE and a proximal DVT who is on anticoagulation?
1 Answer available
Is there any utility in using lytics for loculated malignant pleural effusion?
1 Answer available
Would you consider the use of dual antifibrotic therapy (nintedanib and pirfenidone together) for progressive fibrosing ILD?
4 Answers available
Does your approach to treating latent tuberculosis differ in a patient on anti-fibrotic therapy?
1 Answer available
Do you routinely start full dose anticoagulation in new onset atrial fibrillation in the ICU?
2 Answers available
Do you rule out TB in patients with AIDS and lobar pneumonia?
What’s your threshold to get the three AFBs and place the patient in airborne isolation?
1 Answer available
Do you routinely monitor imaging or pulmonary function in patients with pulmonary TB after the completion of therapy?
1 Answer available
Do you transfuse platelets prior to central line placement in patients with platelet counts less than 50,000?
1 Answer available
What is your approach to PEEP titration in the management of a morbidly obese patient with ARDS?
1 Answer available
Do you routinely use inhaled pulmonary vasodilators in the management of patients with ARDS with refractory hypoxemia?
1 Answer available
Do you use sitting vs supine spirometry to consider tracheostomy in a patient with Amyotrophic Lateral Sclerosis?
1 Answer available
Which hemodynamic parameters can be used to titrate positive pressure ventilation in preload dependent settings such as RV failure, cardiac tamponade, HOCM or hemodynamically significant PE?
2 Answers available
How do you approach treating mild hypercalcemia in patients with sarcoidosis?
1 Answer available
Do you perform spontaneous breathing trials on higher levels of PEEP with extubation to positive pressure ventilation in patients intubated for obesity hypoventilation syndrome?
2 Answers available
Do you routinely use hypertonic saline for pulmonary toileting in patients with non-CF bronchiectasis?
1 Answer available
Is an early chest tube and tPA/Dornase therapy for a loculated and complex pleural effusion that is not an empyema or hemothorax helpful in reducing the rate of developing trapped lung?
1 Answer available
What are your top takeaways from ATS 2023?
2 Answers available
Do you start steroid therapy in a patient with pure ARDS without septic shock, or would you only consider steroids only in those with severe community acquired pneumonia?
To help interpret clinical applications of the CAPE COD (2023) and DEXA ARDS (2020) trials.
2 Answers available
How do you sequence pharmacologic treatments for primary insomnia?
4 Answers available
When do you begin antifibrotic therapy for a patient with newly diagnosed ILD that is not IPF?
Do you base the decision on FEV1, 6MWD or symptoms at initial evaluation, or progression over time?
6 Answers available
Do you routinely continue using TPA/Dornase for treatment of empyema, if there is accumulation of new sero-sanguinous output from the chest tube after the initial treatment?
Are there any quantitative indices (eg. volume, pleural fluid hematocrit) that would impact your decision to stop subsequent TPA/dornase treatments?
1 Answer available
What indicators do you use to determine whether a patient is having a favorable or unfavorable response to nintedanib?
When adding nintedanib what sort of treatment course do you counsel the patient on? Do you plan to continue it indefinitely as long as the patient tol...
3 Answers available
Do you generally recommend starting nintedanib prior to immunosuppressive therapy in a patient with CTD-ILD?
Do you prefer to start with nintedanib and then add immunosuppressive agents, or give a trial of immunosuppressive medication first, then add nintedan...
4 Answers available
What is your approach to management of elderly patients with cardiopulmonary comorbidities and severe pulmonary hypertension?
1 Answer available
Do you screen for interstitial lung disease in patients with newly diagnosed polymyositis or dermatomyositis in the absence of respiratory symptoms?
3 Answers available
What is your threshold to start stress dose steroids in the management of patients with septic shock?
Do you do start therapy at a certain vasopressor requirement?
2 Answers available
How do you define an adequate EBUS when staging NSCLC?
Is there a minimum standard for which stations to sample? Does lymph node size affect your recommendations?
3 Answers available
Are you using NAC in lieu of hypertonic saline amidst the current shortage of hypertonic saline in patients with either CF or non-CF bronchiectasis?
1 Answer available
What is your approach to the monitoring and management of a never-smoker with respiratory symptoms and a nonspecific ventilatory pattern on pulmonary function testing?
1 Answer available
What dose and duration of steroid therapy do you use in steroid responsive ILD?
1 Answer available
What is your next step in management for a patient with immunotherapy induced pneumonitis that does not improve on high dose steroids for 48 hours?
How do you decide between starting infliximab, MMF, or IVIG? If a patient presents in respiratory failure (nearing or requiring intubation), woul...
1 Answer available
Do you employ the use of noctournal oximetry to assess for a need for supplemental O2 in addition to auto PAP in patients with OSA who have not had an in lab CPAP titration study?
2 Answers available
Do you continue methotrexate while starting TNFi therapy in patients with refractory pulmonary sarcoidosis?
3 Answers available
How do you choose between azithromycin and roflumilast in the management of a patient with severe COPD who remains symptomatic with frequent exacerbations despite maximal dose LABA/LAMA/ICS with demonstrated compliance and proper inhaler technique?
1 Answer available
How do you approach treatment of septated parapneumonic pleural effusions that do not satisfy traditional criteria for complicated effusion after diagnostic thoracentesis?
Is there any role of tube thoracostomy as opposed to only antibiotics?
1 Answer available
What is the optimal frequency and duration of post-operative radiological surveillance following resection of a solitary fibrous tumor?
1 Answer available
What is your perspective on the role of respiratory therapists in managing a patient who is dyssynchronous on their current mode of mechanical ventilation?
Do your respiratory therapists independently adjust ventilator settings without direct physician involvement?
2 Answers available
Do you offer immunosuppression to patients with CTD-ILD with concomitant well controlled HIV?
2 Answers available
For NSCLC patients with limited diagnostic tissue that is insufficient for genetic testing, do you offer repeat biopsy (of accessible site), blood based testing, or both to evaluate for actionable driver mutations?
3 Answers available
What is the role for "liquid biopsy" for patients with newly diagnosed metastatic NSCLC?
5 Answers available
Are you using the microbial cell-free DNA “Karius” test to aid in the diagnosis of an atypical pulmonary infection such as PJP or NTM?
2 Answers available
Do you use steroids in patients with respiratory failure who are infected with both influenza and COVID-19?
How do you approach which risk to accept given that steroids have evidence for use in COVID-19 while is suggestion for harm in using steroids in influ...
1 Answer available
Do you use prednisone in the management of patients with persistent respiratory symptoms following acute COVID-19 infection?
4 Answers available
How do you manage recurrent inflammatory pleural effusions in lupus pleuritis?
1 Answer available
What is your approach to counseling a patient with exertional hypoxia, but normal resting oxygen saturation, who is hesitant to use supplemental oxygen therapy?
1 Answer available
How do you complete brain death testing in patients who cannot tolerate apnea testing and are unable to transport for ancillary testing?
For instance, if the patient doesn’t tolerate apnea testing, is too unstable to go for ancillary testing outside the ICU, and TCDs/EEG are unava...
5 Answers available
What steroid regimen do you employ prior to extubating a patient who does not have a suitable cuff leak?
2 Answers available
What is your approach to therapy for pulmonary sarcoidosis resistant to methotrexate?
1 Answer available
What steroid regimen do you use in patients with both septic shock and ARDS?
Do you use hydrocortisone 200 mg/day as studied in ADRENAL/APROCCHSS or dexamethasone 20 mg/day as studied in DEXA-ARDS?
2 Answers available
How would you treat a patient with combined pre- and post-capillary pulmonary hypertension after successfully optimizing post-capillary pressures through a valvular intervention?
2 Answers available
Do you consider the duration of lung/lobar atelectasis in your decision making while offering airway stents for malignant central airway obstruction?
Are patients with long standing malignant central airway obstruction poor candidates for central airway stents? What is considered to be an acceptable...
1 Answer available
Is there any role for palliative radiation in patients who are intubated due to malignant airway obstruction?
Given the substantial risks associated with transporting an intubated and ventilated patient to Radiation Oncology, is there any evidence to support t...
5 Answers available
Do you routinely isolate and test for TB in a patient incidentally found to have a miliary pattern of nodules on chest CT?
2 Answers available
What is your approach to pulmonary vasodilator therapy in patients with COPD and Severe Group 3 Pulmonary Hypertension?
1 Answer available
Do you continue CFTR modulator therapy in patients with extra-pulmonary manifestations of CF after lung transplant?
1 Answer available
What are your preferred ventilatory settings/mode(s) for patients with acute hypoxic respiratory failure presenting with severe biventricular dysfunction in cardiogenic shock?
1 Answer available
Does your approach to the management of a patient with an acute exacerbation of CPFE where the ILD is attributed to IPF differ from the management of a patient with an exacerbation of IPF alone?
1 Answer available
Would you restart prophylactic anticoagulation in a patient with a history of unprovoked PE who received short term anticoagulation with a prior physician?
E.g. low dose DOAC
1 Answer available
What is your preferred management for diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH)?
Does your management change if symptomatic or asymptomatic?
1 Answer available
How would you manage immune check point inhibitor induced capillary leak syndrome refractory to IVIG monotherapy?
1 Answer available
Do you routinely use donor derived cell free DNA levels to guide surveillance bronchoscopies in lung transplant recipients?
2 Answers available
Would you give checkpoint inhibitor therapy to a cancer patient with known dermatomyositis given the association of checkpoint inhibitor associated myocarditis, myasthenia gravis, and myositis?
6 Answers available
Is there a role of everolimus or capecitabine and temozolomide in diffuse idiopathic pulmonary neuroendocrine cell hyperplasia in patients already on octreotide?
1 Answer available
What is your approach to therapy in patients with progressive Scedosporium pulmonary infection who are not candidates for surgical debridement?
1 Answer available
How do you monitor for pulmonary toxicity for patients on trastuzumab deruxtecan?
Would you obtain baseline PFT on all patients or only selected high risk patients? Would you repeat PFTs regularly or only if clinically symptomatic?&...
5 Answers available
Do you routinely use milrinone to augment RV function in patients with massive pulmonary emboli on vasoactive support?
1 Answer available
How do you approach management of limited stage SCLC in a patient with idiopathic pulmonary fibrosis?
3 Answers available
What is your approach to the management of a patient with PAH who is resistant to contraception and planning a pregnancy?
1 Answer available
Are there known biomarkers predictive of IRAEs?
3 Answers available
Do you routinely use sweat tests if you are going to titrate a CF patient onto a lower dose of ETI for any reason (allergy, mental health, etc) to assess the severity of their response to the lower dose?
1 Answer available
Are there any concerns utilizing apremilast for psoriatic arthritis in patients who are also taking roflumilast for COPD?
1 Answer available
Do you prescribe antifibrotics to patients with combined pulmonary fibrosis and emphysema (CPFE)?
1 Answer available
When can abdominal surgery be safely performed for presumptive ovarian cancer in a patient with recent pulmonary emboli?
(Normal oxygenation and echo)
1 Answer available
Is there any PFT criteria that you use in guiding decision making to offer transbronchial lung cryobiopsy to patients with interstitial lung disease?
1 Answer available
What are your top takeaways from CHEST 2022?
2 Answers available
Do you favor the use of maximal inspiratory/expiratory pressure measurement or supine spirometry in the evaluation of a patient with suspected respiratory muscle weakness?
1 Answer available
What is your approach to counseling and management of patients with severe symptomatic OSA whose PAP devices have been recalled?
1 Answer available
Do you treat Candida spp isolated from a bronchoalveolar lavage?
2 Answers available
How do you manage steroid-refractory immune checkpoint inhibitor induced pneumonitis?
4 Answers available
Is there a role for biologic therapies in asthma-COPD overlap syndrome with evidence of type 2 inflammation?
2 Answers available
Do you start PAP in patients who have an overall AHI of less than 5 but demonstrate significant apneas/hypopneas in REM sleep?
1 Answer available
What is your approach to the work up and management of interstitial lung abnormalities?
1 Answer available
How do you approach performing EBUS TBNA in patients with latex allergy?
Apart from removing the latex balloon, do you employ any additional technical accommodations?
1 Answer available
Do you routinely continue airway clearance therapies in the setting of mild to moderate hemoptysis in a patient with CF?
2 Answers available
Would you consider prophylactic antifungal treatment prior to immunosuppressive therapies in a patient with previously treated pulmonary coccidiomycosis and residual parenchymal changes?
1 Answer available
Do you often see clinical improvement that is significant enough to de-list patients with CF for transplant after the initiation of CFTR modulator therapy?
2 Answers available
Do you ever stop tobramycin prophylaxis in a patient with chronic bronchiectasis previously colonized with pseudomonas?
2 Answers available
Do you perform a clamp trial before removing a chest tube for pneumothorax?
2 Answers available
Do you do recommend further mediastinal staging for patients with SCLC or inoperable NSCLC with N1 disease on PET?
If a patient clearly has N1 disease with high SUV on PET, do you routinely recommend EBUS or mediastinoscopy to evaluate for N2 disease?
1 Answer available
What is your preferred steroid sparing therapy in a patient experiencing a severe checkpoint inhibitor toxicity and not responding to high dose IV steroids?
2 Answers available
What patient characteristics would lead you to opt for triple therapy versus double therapy in newly diagnosed PAH?
1 Answer available
Do you give intrapleural lytics for complicated effusion/empyema in patients on systemic anticoagulation?
1 Answer available
What patient related factors and hemodynamic parameters would lead you to avoid transbronchial biopsies in patients with pulmonary hypertension?
1 Answer available
What steroid regimen do you employ in the treatment of patients with post COVID-19 pulmonary fibrosis?
2 Answers available
Do you ever employ the use of prolonged periods of pressure support ventilation as means of "weaning" in the management of patients with acute respiratory failure?
1 Answer available
How would you manage subclinical ILD associated with MDA-5 Dermatomyositis?
Any indications for triple therapy in the patients with subclinical ILD associated with MDA-5 dermatomyositis?
1 Answer available
Would you consider PLEX for patients with DAH from SLE-associated capillaritis?
1 Answer available
How frequently do you monitor LFTs and CBC after initiating endothelin receptor antagonists?
Is there a difference in monitoring frequency for legacy drugs like bosentan vs newer agents (macitentan, ambrisentan)?
3 Answers available
Do you find that complete interlobar fissures on HRCT correlate well with decreased collateral ventilation on endoscopic balloon occlusion in the evaluation and placement of endobronchial valves for bronchoscopic lung volume reduction?
2 Answers available
Do you favor the use of Fick or thermodiluation to measure cardiac output in patients with interstitial lung disease with suspected pulmonary hypertension?
Occasionally, supplemental oxygen may alter Fick measurements giving falsely high CO and falsely low PVR, therefore is Thermodilution method preferred...
2 Answers available
Which images do you routinely request when ordering a HRCT chest?
1 Answer available
In a patient with history of pneumonectomy would you consider SBRT for treatment of a new tumor in the remaining lung?
1 Answer available
How do you prescribe a steroid taper for radiation and checkpoint inhibitor related pneumonitis?
I've seen a handful of fatal radiation pneumonitis associated with rapid steroid tapers by the non-treating physicians. How do you recommend prescribi...
1 Answer available
When do you consider Balloon Pulmonary Angioplasty in patients with inoperable CTEPH?
1 Answer available
Do you consider extensive clot burden as a factor in determining whether patients with submassive PE may be appropriate for thrombolytic therapy?
3 Answers available
Do you consider bronchoscopic lung volume reduction in patients with homogenous emphysema?
1 Answer available
Do you consider the use of bevacizumab in patients with HHT who have high output cardiac failure related to liver AVMs who also have cerebral AVMs?
1 Answer available
What workup do you do for patients who have PL-7 elevation when screening for myopathy?
2 Answers available
Do you recommend the use of endobronchial valves in the management of patients with spontaneous pneumothorax with persistent air leak?
1 Answer available
What are your top takeaways in Thoracic Cancers from ASCO 2022?
What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice?
6 Answers available
Do you recommend the use of indwelling pleural catheters in the management of patients with hepatic hydrothorax requiring frequent drainage?
1 Answer available
What criteria do you use to consider pleurodesis vs indwelling tunneled catheters in patients with malignant pleural effusion?
1 Answer available
How do you counsel patients regarding prognosis following a diagnosis of IPF?
1 Answer available
How do you approach a thoracic lymph node that is highly suspicious on CT and PET but negative on EBUS in patients with NSCLC?
3 Answers available
Is there a role for immunosuppression in addition to standard PAH therapy in the management of pulmonary hypertension associated with primary Sjogrens syndrome?
Assuming other non CTD related causes for PAH have been excluded
1 Answer available
Do you adjust immunosuppression in lung transplant recipients diagnosed with COVID-19?
2 Answers available
Is there a role for the use of inhaled corticosteroids in patients with pulmonary sarcoidosis who have stage II or III disease with abnormal lung function but only mild respiratory symptoms?
1 Answer available
How do you clinically distinguish between group I and group III PH in patients with CTD-ILD?
1 Answer available
Do you utilize soluble IL-2 receptor or ACE levels as serum biomarkers to monitor disease activity in pulmonary sarcoidosis?
1 Answer available
Based on findings of the INCREASE trial, are you routinely prescribing inhaled treprostinil to patients with group 3 pulmonary hypertension secondary to interstitial lung disease?
1 Answer available
How do you manage a stenotic airway following SBRT or hypofractionated radiation to a central lung tumor?
Are there situations in which you would recommend dilation of stenotic airways after radiation? Is there a concern for increased complications of dila...
1 Answer available
How do you treat patients with sarcoid who have persistent symptoms after an initial 6 week course of corticosteroids?
3 Answers available
Do you consider the use of antifibrotics at presentation in patients with a radiographic UIP pattern of pulmonary fibrosis in the presence of positive serologies without any symptoms of CTD who have not yet demonstrated evidence of a progressive phenotype?
1 Answer available
Do you de-escalate airway clearance therapies in patients with CF who experience an improvement in mucus production and clearance after CFTR modulator therapy is started?
1 Answer available
Do you employ the use of extracorporeal photopheresis in the management of patients with progressive BOS following lung transplantation?
Clinical trial NCT02181257 to explore this currently in process
1 Answer available
Do you employ the use of external chest compression with sandbags in the management of patients with severe ARDS who are not candidates for proning?
1 Answer available
When would you consider biopsy for an incidentally noted, PET negative, solid, solitary pulmonary nodule that is >8mm in size?
1 Answer available
Is there a role for antifibrotic therapy in post COVID-19 pulmonary fibrosis?
1 Answer available
Do you consider EBUS TBNA in the diagnostic evaluation of patients with mediastinal lymphadenopathy with concern for lymphoma?
1 Answer available
What are best practices for engaging with multidisciplinary colleagues to ensure patients with earlier stage NSCLC are being appropriately considered for novel adjuvant therapies?
How are your teams effectively evaluating and counseling patients to ensure they are prepared for potential extended adjuvant treatment approaches? Is...
4 Answers available
What is your approach to treatment for a patient with progressive ILD (UIP pattern) with high titer RF but no articular symptoms?
1 Answer available
Would you advise a patient with quiescent vasculitis who flared with the first Covid mRNA vaccine to obtain an additional dose?
Would you suggest switching to a viral vector vaccine, such as J&J?
2 Answers available
Would you offer adjuvant chemotherapy, osimertinib, or both to a patient with Stage IB EGFR mutated lung adenocarcinoma found in the lung explant pathology after bilateral lung transplant?
Would you consider the immune suppressed status of the patient as a high risk factor to offer adjuvant therapy?
1 Answer available
How do you treat multisystem sarcoidosis refractory to methotrexate, humira, and remicade?
2 Answers available
What strategies can be employed to manage interstitial lung disease seen with trastuzumab deruxtecan?
Can patients be re-challenged after developing ILD? Is the toxicity seen with T-Dxd a potential barrier to use?  Do you feel the dosing used in...
2 Answers available
How would you approach treatment for fulminant RA-associated ILD?
Would you discontinue Methotrexate and TNF inhibitors even if previously no side effects from these medications, and would you consider Cyclophosphami...
1 Answer available
What are your recommendations regarding methotrexate usage in patients with persistent chest CT changes post COVID pneumonia?
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?
2 Answers available
How do you evaluate a suspicious, but negative pleural effusion when working up NSCLC and SCLC?
Are two negative pleurocentesis' adequate to conclude that the patient does not have metastatic disease? Do you routinely recommend VATS and pleural b...
1 Answer available
Do you routinely recommend a sleep study in patients with clinical history of REM-sleep behavior disorder?
Does this add any value?
1 Answer available
What criteria do you use on echocardiogram and PFT to determine who needs further evaluation for CTD-associated pulmonary hypertension?
1 Answer available
What indicators do you use to identify patients with CTD-ILD who do not have potential to improve from continued immunosuppressive therapy?
Do you use imaging (fibrosis vs. pneumonitis), PFTs, duration of prior immunosuppressive therapy?
1 Answer available
What is your preferred regimen for remission induction and maintenance in EGPA with cardiac involvement?
1 Answer available
How do you approach patients with ANCA vasculitis who had partial response, but continue to have disease activity on q 6 month maintenance rituximab and remain on steroids?
Would you change rituximab maintenance dose or schedule?
1 Answer available
How do you choose between oral and IV cyclophosphamide for the treatment of ANCA-associated vasculitis?
1 Answer available
What is your approach for a symptomatic inpatient with locally advanced NSCLC who cannot have a PET?
Would you consider treating the full mediastinum or any mildly enlarged nodes, even contralateral? Do you have a strategy that transitions from a pall...
2 Answers available
What immunosuppressive agents aside from steroids would you use to treat bronchiolitis obliterans in a patient with long-standing seropositive RA?
1 Answer available
How do you approach the management of SSc-ILD in a patient on immune checkpoint therapy?
1 Answer available
Would you use inhaled steroids with or without oral steroids for the treatment of radiation pneumonitis?
Would inhaled steroids help reduce the PO dose and/or significantly accelerate tapering?  If s, for what pneumonitis grade? What specific steroid...
1 Answer available
How do you treat an AAV patient with recurrent bronchial stenosis that has not responded to rituximab induction therapy and dilatations?
1 Answer available
Are there any concerns about using nintedanib in a patient with progressive fibrosing ILD on background mycophenolate?
1 Answer available
Is positive pleural fluid cytology from pleural mesothelioma considered M+?
Should patient be considered for definitive therapy or chemo alone if pleural cytology positive but no T4, N2, or sarcomatoid features?
1 Answer available
How do you treat CTD-associated organizing pneumonia?
How is your approach to treatment different than other ILD patterns such as NSIP? Does treatment response vary based on underlying CTD?
2 Answers available
How will you use tocilizumab in the treatment algorithm for SSc-ILD, given its recent FDA approval?
1 Answer available
How do you treat RA in patients with pulmonary mycobacterium avium complex (MAC) infections?
1 Answer available
How do you manage end-organ toxicity such as hepatotoxicity or pulmonary toxicity in a patient receiving RET-inhibitors for NSCLC?
3 Answers available
What is your approach to treatment for MDA5 dermatomyositis patients with rapidly progressive ILD?
Cyclophosphamide/tacrolimus and Rituximab have been used in conjunction with steroids in case series.
1 Answer available
Is there a role for anti-IL6 therapy in SSc-associated ILD?
1 Answer available
Are there AAV patients for whom you would consider combination therapy with cyclophosphamide and rituximab?
1 Answer available
Can liquid biopsy be substituted for tissue biopsy in a lung mass that is radiologically suspicious for primary lung cancer when CT-guided biopsy cannot be done?
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?
2 Answers available
What is considered an adequate treatment period to assess response of AAV induction therapy with rituximab or cyclophosphamide? 
1 Answer available
Which EGPA patients are most likely to benefit from treatment with anti-IL-5 agents such as mepolizumab?
1 Answer available
What steroid sparing agent do you use for treatment of cardiac sarcoidosis?
Does the type of cardiac involvement impact this choice?
2 Answers available
Should MTX be avoided in RA patients with asymptomatic lung nodules?
If so, what would be an ideal DMARD in this setting?
1 Answer available
What is the optimal management of patients with stage II lung cancer without nodal metastasis, but unresectable due to poor pulmonary reserve?
For T2bN0 or T3N0 disease, you consider radiation alone, sequential radiation followed by chemotherapy, or concurrent chemoradiation?
2 Answers available
Do you consider cystic fibrosis a contraindication to lung SBRT for primary NSCLC or oligometastases?
1 Answer available
How would you manage a patient with newly diagnosed locally advanced NSCLC and concurrent, active tuberculosis on anti-TB therapy?
After initiation of anti-TB treatment and 3 negative AFB smears, would you initiate concurrent chemoRT? Would you give sequential RT then chemo to giv...
1 Answer available
Which ANCA vasculitis patients are better candidates for cyclophosphamide rather than rituximab?
2 Answers available
How does your treatment algorithm differ for drug-induced ANCA vasculitis compared to non drug-induced ANCA vasculitis in cases with severe/organ-threatening manifestations?
1 Answer available
Are there certain subsets of ANCA vasculitis patients for whom you would consider life long maintenance therapy?
2 Answers available
When a patient presents with 2 lung lesions, do you routinely recommend a biopsy of both lung lesions?
Would your practice change if the patient had N2 disease?
1 Answer available
Should methotrexate be categorically avoided in RA patients with COPD or RA-ILD?
1 Answer available
How do you manage calcium and vitamin D supplementation in patients with sarcoidosis on chronic steroids?
1 Answer available
What clinical factors do you use to determine timing of on-demand dosing of rituximab in ANCA vasculitis maintenance therapy?
1 Answer available
Do you recommend on-demand versus fixed-schedule dosing for rituximab maintenance in ANCA vasculitis?
 If you use both, how do you decide which to use for a particular patient?
2 Answers available
What is the role of nintedanib in the treatment of SSc-ILD?
The SENSCIS trial was published in 2019 on efficacy of this agent. However, it's not clear where this should be in the treatment algorithm: Monot...
2 Answers available
When do you use tacrolimus in patients with myositis-related interstitial lung disease?
1 Answer available
How do you manage early and symptomatic fibrosis in lung cancer patients after RT?
I’ve noticed some patients develop worsening SOB and DOE months after RT and rather than interstitial diffuse pattern you would see with pneumon...
2 Answers available
What agent do you try next in patients with myositis-related interstitial lung disease who are refractory to mycophenolate mofetil and azathioprine?
1 Answer available
When do you stop immunosuppressants in patients with GPA?
1 Answer available
What is your next step in patients with polymyositis without interstitial lung disease who are refractory to methotrexate?
1 Answer available
Is there an increased risk of pneumonitis in COVID-19+ patients receiving lung irradiation?
Any differences in the risks between SBRT vs. conventionally fractionation? Concurrent immunotherapy? 
1 Answer available
How do you treat extensive stage small cell lung cancer in the very elderly (more than 80 yrs)?
1 Answer available
Do you use an age limit cutoff for SBRT in lung cancer?
Is there a certain age beyond which it is not safe to do SBRT?
1 Answer available
How has COVID-19 altered your recommendations for invasive mediastinal staging for NSCLC?
Should staging and treatment decisions be made based on imaging alone?
2 Answers available
How would you treat a patient with extensive-stage small cell carcinoma and severe end-stage COPD on home oxygen?
Would you treat with chemotherapy (carboplatin/etoposide) vs anti-pd-1 monotherapy vs combination chemoimmunotherapy vs supportive care?
2 Answers available
In a patient with ILD and metastatic NSCLC with positive PD-L1, would you give chemo/pembrolizumab, chemotherapy alone, or pembrolizumab alone?
Does the degree of PD-L1 expression weigh into your decision? 
1 Answer available
How do you approach elderly patients with stage III NSCLC who have a reasonable performance status?
Do you recommend or make any modifications in the PACIFIC regimen for patients > 75 years of age?
1 Answer available
How do you identify immunotherapy-related pneumonitis vs. radiation pneumonitis in a patient status post chemoradiation receiving consolidation immunotherapy?
Is IO related pneumonitis in the radiation field or more diffuse?
1 Answer available
What is your approach for a primary tracheal squamous cell carcinoma?
If clinically node negative, would you add elective nodal radiation?Does it depend on location (upper vs. lower trachea)?
1 Answer available
Should patients with idiopathic pulmonary fibrosis be placed on nintedanib or pirfenidone before starting radiotherapy for lung cancer?
1 Answer available
How important is a severely diminished diffusion capacity in determining whether to offer a lung cancer patient radiotherapy?
Does it factor into your decision making in the setting of restricted spirometry and normal lung volumes? Does this differ for SBRT v. chemoRT?
1 Answer available
How would you manage palliation in a patient with postobstructive pneumonia caused by a mediastinal mass?
Would you treat if there is active infection?  How much improvement would you expect?
1 Answer available
How are you using liquid biopsy in the routine management of your patients with metastatic NSCLC?
Are you using ctDNA blood tests for targetable mutations at the time of diagnosis, at the time of disease progression, or not at all?
2 Answers available
How do you approach the workup of subcentimeter contralateral nodules in cases of locally advanced NSCLC?
When there is biopsy proven mediastinal disease, do you offer definitive chemoradiation and monitor, or do you try to prove the presence/absence ...
1 Answer available
What factors do you consider to help guide treatment for patients with high grade large cell neuroendocrine cancers of the lung?
Do you incoprate Ki67% or mitotic rate into your treatment decision, and is there any use for somatostatin based imaging such as octreoscan or gallium...
1 Answer available
How do you manage an adult primary rhabdomyosarcoma of the lung/mediastinum?
Is there any role for consolidative RT/CRT to the lung and mediastinum after initial chemo? What dose and fractionation would be most appropriate for ...
1 Answer available
Do you consider idiopathic pulmonary fibrosis a contraindication to lung SBRT?
There are varying reports in the literature which seem to suggest increased rates of Gr 4-5 pneumonitis in IPF patients.  How do you manage these...
2 Answers available
Do you use anti-PD-1/anti-PD-L1 therapies in lung cancer patients with a prior history of radiation pneumonitis?
What about patients who are still on steroids for radiation pneumonitis? 
1 Answer available
When is it considered inappropriate to omit pathological mediastinal lymph node staging for non-small cell lung cancer?
The NCCN guidelines call for pathological mediastinal lymph node staging for all NSCLC except in solid tumors <1cm and non-solid lesions < ...
3 Answers available
When do you start steroids for radiation pneumonitis?
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...
3 Answers available
How do you approach lung tumors with vessel encasement, especially in someone with active hemoptysis?
Is there any concern about hemorrhage from treatment effect on tumor? Would SABR worsen the chance of fatal hemorrhage/hemoptysis and if so, would you...
1 Answer available
What are your criteria for treating a patient with lung SBRT in the absence of a biopsy?
Roughly what percentage of patients are treated without a biopsy?
1 Answer available
If a PET/CT scan is positive for mediastinal lymph node involvement, is a mediastinoscopy or EBUS still required for NSCLC staging?
In practice, do you send patients with N2/3 disease for mediastinal staging if not offered upfront?
1 Answer available


Papers discussed in this category

Radiother Oncol, 2011 Nov
Outcomes of stereotactic ablative radiotherapy following a clinical diagnosis of stage I NSCLC: comparison with a contemporaneous cohort with pathologically proven disease.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2006-10-20
Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer.
N Engl J Med, 2023 Feb 09
Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer.
Lancet (London, England), 2022 Apr 23
Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial.
J Thorac Cardiovasc Surg, 2011 Mar
Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030 Trial.
Semin Radiat Oncol, 2015 Oct
Predicting Radiotherapy Responses and Treatment Outcomes Through Analysis of Circulating Tumor DNA.
J. Clin. Oncol., 2008-07-20
Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group.
Chest, 2007 Sep
Invasive mediastinal staging of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition).
JCO Precision Oncology, 2017 Sep 29
Circulating Tumor DNA in Non–Small-Cell Lung Cancer: A Primer for the Clinician
Sci Rep, 2014 Sep 09
Diagnostic value of circulating free DNA for the detection of EGFR mutation status in NSCLC: a systematic review and meta-analysis.
Medicine (Baltimore),
Blood as a Substitute for Tumor Tissue in Detecting EGFR Mutations for Guiding EGFR TKIs Treatment of Nonsmall Cell Lung Cancer: A Systematic Review and Meta-Analysis.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-10-01
Association Between Plasma Genotyping and Outcomes of Treatment With Osimertinib (AZD9291) in Advanced Non-Small-Cell Lung Cancer.
Lung cancer (Amsterdam, Netherlands), 1994-03
Toxicity of thoracic radiotherapy on pulmonary function in lung cancer.
Clin Lung Cancer, 2017 Jul 10
Impact of Pretreatment Interstitial Lung Disease on Radiation Pneumonitis and Survival in Patients Treated With Lung Stereotactic Body Radiation Therapy (SBRT).
J Thorac Oncol,
Impact of pretreatment interstitial lung disease on radiation pneumonitis and survival after stereotactic body radiation therapy for lung cancer.
Clinical lung cancer, 2018-07
Fatal Radiation Pneumonitis in Patients With Subclinical Interstitial Lung Disease.
Int. J. Radiat. Oncol. Biol. Phys., 2017 Mar 15
Treatment-Related Toxicity in Patients With Early-Stage Non-Small Cell Lung Cancer and Coexisting Interstitial Lung Disease: A Systematic Review.
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2016-06
Pre-treatment non-target lung FDG-PET uptake predicts symptomatic radiation pneumonitis following Stereotactic Ablative Radiotherapy (SABR).
Journal of vascular and interventional radiology : JVIR, 2021 Mar 31
Effectiveness of Thermal Ablation and Stereotactic Radiotherapy Based on Stage I Lung Cancer Histology.
Int. J. Radiat. Oncol. Biol. Phys., 2010-06-01
Selective nodal irradiation on basis of (18)FDG-PET scans in limited-disease small-cell lung cancer: a prospective study.
Thorac Cancer, 2017 Apr 24
Relationship between endobronchial ultrasound-guided (EBUS)-transbronchial needle aspiration utility and computed tomography staging, node size at EBUS, and positron emission tomography scan node standard uptake values: A retrospective analysis.
International journal of radiation oncology, biology, physics, 2013-03-01
Poor baseline pulmonary function may not increase the risk of radiation-induced lung toxicity.
Respir. Res., 2018 Apr 24
Abnormal pulmonary function tests predict the development of radiation-induced pneumonitis in advanced non-small cell lung Cancer.
Radiographics : a review publication of the Radiological Society of North America, Inc, 2004
Effects of radiation therapy on the lung: radiologic appearances and differential diagnosis.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2017-03
Pneumonitis in Patients Treated With Anti-Programmed Death-1/Programmed Death Ligand 1 Therapy.
The New England journal of medicine, 2015-07-16
Anti-PD-1-Related Pneumonitis during Cancer Immunotherapy.
N Engl J Med, 2017 Nov 16
Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer.
The New England journal of medicine, 2018-12-06
First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010-01-10
Phase I study of accelerated conformal radiotherapy for stage I non-small-cell lung cancer in patients with pulmonary dysfunction: CALGB 39904.
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2014-04
Management of mediastinal relapse after treatment with stereotactic body radiotherapy or accelerated hypofractionated radiotherapy for stage I/II non-small-cell lung cancer.
Clinical lung cancer, 2017-07
Stereotactic Body Radiotherapy for Large (> 5 cm) Non-Small-Cell Lung Cancer.
Int. J. Radiat. Oncol. Biol. Phys., 2020 Feb 07
Definitive Management of Presumed Synchronous Early Stage Non-Small Cell Lung Cancers: Outcomes and Utility of Stereotactic Ablative Radiation Therapy.
Cureus, 2019 Jun 22
Moderately Hypofractionated Radiotherapy Alone for Stage I-IIB Non-small Cell Lung Cancer.
Lung Cancer, 2009 Jan 24
Fractionated stereotactic body radiation therapy for medically inoperable stage I lung cancer adjacent to central large bronchus.
Radiat Oncol, 2016 Dec 03
SBRT for centrally localized NSCLC - What is too central?
Adv Radiat Oncol, 2020 May 05
Need for Caution in the Diagnosis of Radiation Pneumonitis in the COVID-19 Pandemic.
Cancer Discov, 2020 May 01
Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System.
Lancet, 2020 May 28
Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study.
Int. J. Radiat. Oncol. Biol. Phys., 2020 Apr 14
Practice Recommendations for Risk-Adapted Head and Neck Cancer Radiation Therapy During the COVID-19 Pandemic: An ASTRO-ESTRO Consensus Statement.
N Engl J Med, 2020 Feb 13
Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis.
The New England journal of medicine, 2010-07-15
Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis.
Medicine (Baltimore),
The Five-Factor Score revisited: assessment of prognoses of systemic necrotizing vasculitides based on the French Vasculitis Study Group (FVSG) cohort.
The New England journal of medicine, 2010-07-15
Rituximab versus cyclophosphamide for ANCA-associated vasculitis.
N. Engl. J. Med., 2019 May 20
Nintedanib for Systemic Sclerosis-Associated Interstitial Lung Disease.
The Lancet. Respiratory medicine, 2016-09
Mycophenolate mofetil versus oral cyclophosphamide in scleroderma-related interstitial lung disease (SLS II): a randomised controlled, double-blind, parallel group trial.
The New England journal of medicine, 2006-06-22
Cyclophosphamide versus placebo in scleroderma lung disease.
J Thorac Oncol, 2020 Feb 24
A Primer on Interstitial Lung Disease and Thoracic Radiation.
Cancer Treat Rev, 2022 Mar 12
Multidisciplinary clinical guidance on trastuzumab deruxtecan (T-DXd)-related interstitial lung disease/pneumonitis-Focus on proactive monitoring, diagnosis, and management.
Archives of internal medicine, 2008-09-22
Methotrexate is not associated with progression of interstitial lung disease in rheumatoid arthritis.
Arthritis and rheumatism, 2010-06
Incidence and mortality of interstitial lung disease in rheumatoid arthritis: a population-based study.
Ann. Rheum. Dis., 2018 Apr 25
Comparison of individually tailored versus fixed-schedule rituximab regimen to maintain ANCA-associated vasculitis remission: results of a multicentre, randomised controlled, phase III trial (MAINRITSAN2).
Ann. Rheum. Dis., 2017 May 25
Randomised controlled trial of prolonged treatment in the remission phase of ANCA-associated vasculitis.
Ann. Rheum. Dis., 2018 May 03
Long-term efficacy of remission-maintenance regimens for ANCA-associated vasculitides.
Chest, 2007-07
Natural history of stage I non-small cell lung cancer: implications for early detection.
Radiat Oncol, 2016 Apr 18
The clinical results of proton beam therapy in patients with idiopathic pulmonary fibrosis: a single center experience.
Journal of the National Cancer Institute, 2011-10-05
Sequential vs. concurrent chemoradiation for stage III non-small cell lung cancer: randomized phase III trial RTOG 9410.
BMC Cancer, 2018 Oct 12
Efficacy and safety of concurrent anti-Cancer and anti-tuberculosis chemotherapy in Cancer patients with active Mycobacterium tuberculosis: a retrospective study.
Semin Arthritis Rheum, 2020 Jun
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