RESPIRATORY
RESPIRATORY
Embedded Files
PULMONARY FIBROSIS
PULMONARY FIBROSIS
Introduction
5 minIntroduction
Introduce yourself and the group
Provide rationale for the session and relevance to clinical practice
Outline learning objectives:
- Be able to take a focused history from a patient presenting with pulmonary fibrosis and consider appropriate differential diagnoses
- Suggest and interpret results of relevant investigations for suspected pulmonary fibrosis
- Understand principles of management for patients with pulmonary fibrosis
Explain structure of session
Total time:
60 minNumber of students:
1-5Grade of students:
3rd to 5th year medical studentsCreated by:
Dr Charlotte HaydenUploaded:
10th February 2020Last updated:
10th February 2020Resources needed for this session:
Resources needed for this session:
Pen, paper, whiteboard or flipchart paper if possible
Students can scan the QR code opposite to view all investigation results on their phone as you work through the session.
Resources linked to this session:
Resources linked to this session:
None
Activity 1: Pathophysiology
5 minActivity 1: Pathophysiology
Before going to see a patient with suspected pulmonary fibrosis, ask the student(s) to suggest underlying causes of pulmonary fibrosis.
Discuss:
- What questions would be useful to distinguish between different causes of fibrosis?
- What questions are important to quantify the impact of disease on the patient?
Activity 2: History Taking and Examination Skills
25 minActivity 2: History Taking and Examination Skills
Ask student(s) to take a focused history and perform a focused respiratory examination on a patient with suspected pulmonary fibrosis. Use the questions discussed earlier as prompts.
This can be observed if capacity of tutors allows.
Activity 3: Diagnostic Reasoning
5 minActivity 3: Diagnostic Reasoning
Ask the student to summarise the key positive and negative findings of the case. Feedback on examination technique and presentation (max 1 minute).
Discussion points:
- What differential diagnoses have you considered and why are these less likely?
- What initial investigations would be useful and what are you expecting them to show?
Activity 4: Radiology Interpretation
5 minActivity 4: Radiology Interpretation
Allow the student(s) to view the patient’s chest x-ray. If none is available, use the example opposite.
Ask the student(s) to identify the key abnormalities on the chest radiograph:
- What is the most obvious abnormality?
- What might be the next best imaging test to confirm the diagnosis?
Discuss the HRCT image opposite:
- How could the changes seen in lungs be described?
Briefly introduce students to the terminology associated with patterns of interstitial lung disease e.g. UIP, AIP, NSIP (nb. understanding the meaning of each of these terms and how they differ is likely to be above the level of students' required knowledge).
Activity 5: Management
5 minActivity 5: Management
Discuss with students key principles of management of pulmonary fibrosis including:
- Conservative: breathlessness management techniques, pulmonary rehabilitation, symptom management
- Medical: role of steroids and antifibrotic agents
- Surgical: role of surgery
Summary and Feedback
5 minSummary and Feedback
Questions
Identify and summarise key learning points (key three points if possible)
Feedback to student – highlight further learning needs
Feedback for teacher - ask students to provide feedback using the QR code opposite
Close
References and Further Reading
References and Further Reading
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