High-Yield Topics
Board-aligned summaries organized by PCCM certification exam categories. 24 topics available.
Acute Respiratory Distress Syndrome (ARDS)
ARDS is a life-threatening form of respiratory failure characterized by acute onset, bilateral pulmonary infiltrates, severe hypoxemia (P/F ≤300), and absence of cardiogenic pulmonary edema. The 2023 Global Definition expanded ARDS to include non-intubated patients on high-flow nasal cannula or NIV.
Idiopathic Pulmonary Fibrosis (IPF)
IPF is a chronic, progressive fibrosing interstitial pneumonia of unknown cause, occurring primarily in older adults. It is the most common idiopathic interstitial pneumonia and carries a median survival of 3–5 years from diagnosis. The pathologic pattern is usual interstitial pneumonia (UIP).
Sepsis & Septic Shock
Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection (Sepsis-3 definition, 2016). Septic shock is a subset with circulatory, cellular, and metabolic abnormalities: vasopressor requirement to maintain MAP ≥65 and serum lactate >2 mmol/L despite adequate fluid resuscitation.
Mechanical Ventilation: Principles & Management
Mechanical ventilation provides respiratory support for patients with respiratory failure. Key goals are to maintain adequate gas exchange while minimizing ventilator-induced lung injury (VILI). Understanding modes, settings, and weaning is essential for every intensivist.
Shock: Classification, Diagnosis & Management
Shock is a state of circulatory failure resulting in inadequate oxygen delivery to meet tissue metabolic demands. Early recognition and classification guide targeted resuscitation. The four types are distributive, hypovolemic, cardiogenic, and obstructive.
COPD: Diagnosis, Staging & Management
COPD is a common, preventable, and treatable disease characterized by persistent airflow limitation due to airway and/or alveolar abnormalities, usually caused by significant exposure to noxious particles or gases (primarily cigarette smoke). GOLD 2024 guidelines provide the current framework.
Asthma: Diagnosis, Classification & Management
Asthma is a heterogeneous disease characterized by chronic airway inflammation, variable airflow obstruction, and bronchial hyperresponsiveness. GINA 2024 guidelines emphasize phenotyping and personalized treatment, particularly with biologics for severe asthma.
Sarcoidosis
Sarcoidosis is a multisystem granulomatous disease of unknown etiology, most commonly affecting the lungs and lymph nodes. It predominantly affects adults aged 20–40 and is more common and severe in Black Americans. Diagnosis requires compatible clinical/radiologic findings plus non-caseating granulomas on biopsy.
Hypersensitivity Pneumonitis (HP)
Hypersensitivity pneumonitis (extrinsic allergic alveolitis) is an immune-mediated ILD caused by inhalation of organic antigens in susceptible individuals. It can present as acute, subacute, or chronic (fibrotic) forms. Chronic fibrotic HP has a prognosis similar to IPF.
Pulmonary Arterial Hypertension (PAH)
PAH (Group 1 PH) is characterized by progressive pulmonary vascular remodeling leading to elevated PVR, right heart failure, and death. The 2022 ESC/ERS guidelines recommend risk stratification and upfront combination therapy for most patients.
Pulmonary Embolism (PE): Diagnosis & Management
Pulmonary embolism is a potentially life-threatening condition caused by thrombus (or other material) obstructing the pulmonary arterial circulation. Risk stratification guides treatment intensity, from anticoagulation alone to systemic thrombolysis or surgical embolectomy.
Obstructive Sleep Apnea (OSA)
OSA is the most common sleep-disordered breathing disorder, characterized by repetitive upper airway obstruction during sleep causing hypoxemia, hypercapnia, and sleep fragmentation. It is strongly associated with cardiovascular disease, metabolic syndrome, and neurocognitive impairment.
Community-Acquired Pneumonia (CAP)
CAP is one of the most common infectious causes of hospitalization and death worldwide. The 2019 ATS/IDSA guidelines provide evidence-based recommendations for diagnosis, severity assessment, and antimicrobial therapy.
Lung Cancer: Staging, Workup & Treatment Overview
Lung cancer is the leading cause of cancer death in the US. NSCLC accounts for 85% of cases. Molecular profiling has transformed treatment, with targeted therapies available for EGFR, ALK, ROS1, KRAS G12C, BRAF V600E, MET exon 14, RET, and NTRK alterations.
Pleural Effusion: Diagnosis & Management
Pleural effusions are classified as transudates or exudates using Light's criteria. The most common causes are heart failure (transudate), malignancy, and parapneumonic effusion (exudates). Accurate diagnosis requires thoracentesis with appropriate fluid analysis.
Flexible Bronchoscopy: Indications, Technique & Complications
Flexible bronchoscopy is the most commonly performed interventional pulmonary procedure. It allows direct visualization of the airways to the subsegmental level and enables diagnostic sampling (BAL, brushings, biopsies) and therapeutic interventions.
Endobronchial Ultrasound (EBUS)
EBUS combines bronchoscopy with ultrasound to enable real-time guided sampling of mediastinal and hilar lymph nodes and masses. Linear EBUS-TBNA has largely replaced mediastinoscopy for mediastinal staging of lung cancer and diagnosis of mediastinal lymphadenopathy.
Navigational Bronchoscopy & Robotic Bronchoscopy
Navigational bronchoscopy technologies extend the reach of flexible bronchoscopy to peripheral pulmonary lesions beyond the direct visualization range. Electromagnetic navigation (EMN) and robotic-assisted bronchoscopy (Ion, Monarch) enable biopsy of peripheral nodules with improved reach and stability.
Bronchial Thermoplasty
Bronchial thermoplasty (BT) is a bronchoscopic procedure that delivers controlled radiofrequency energy to the airway wall to reduce airway smooth muscle mass, decreasing bronchoconstriction in severe asthma. It is performed in three sessions over 3 weeks.
Endobronchial Valves for Severe Emphysema
Endobronchial valves (EBV) are one-way valves placed bronchoscopically to achieve lobar atelectasis in patients with severe heterogeneous emphysema, reducing hyperinflation and improving lung function. Patient selection requires intact interlobar fissures (no collateral ventilation).
Cryotherapy & Transbronchial Cryobiopsy
Cryotherapy uses extreme cold (-89°C) delivered via a flexible cryoprobe to freeze and destroy endobronchial tissue (tumor debulking, granulation tissue) or to obtain large, well-preserved tissue biopsies. Cryobiopsy has become an important tool for ILD diagnosis.
Rigid Bronchoscopy & Airway Stenting
Rigid bronchoscopy provides a large-bore airway conduit for management of central airway obstruction (CAO), massive hemoptysis, and foreign body removal. It is performed under general anesthesia and allows use of multiple therapeutic modalities including laser, APC, cryotherapy, and stent deployment.
Medical Thoracoscopy (Pleuroscopy)
Medical thoracoscopy (pleuroscopy) is a minimally invasive procedure performed under conscious sedation to directly visualize the pleural space, obtain pleural biopsies, and perform therapeutic interventions such as talc poudrage for pleurodesis.
Pulmonary Function Test (PFT) Interpretation
PFT interpretation is a core clinical skill for pulmonologists. A systematic approach to spirometry, lung volumes, and DLCO allows accurate characterization of obstructive, restrictive, and mixed patterns, and guides diagnosis and management.