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Pulmonary Medicine

The use of NIPPV therapy to treat  patients with acute respiratory failure

Michael P. Merren, MSM, MMSc, PA-C, AA-C November 09, 2011

Appropriate use of noninvasive positive pressure ventilation can decrease the morbidity and mortality rates associated with standard treatment for ARF.

Cauda equina syndrome and acute respiratory distress syndrome

Jami S. Smith, MPA, PA-C, Peter Sandor, MHS, PA-C, RRT September 27, 2011

This article reviews the general features, clinical assessment, diagnosis, and treatment of acute respiratory distress syndrome and cauda equina syndrome.

Reduced lung function and bullae  resulting from illicit drug use

Amy L. Jay, PA-C July 25, 2011

A male patient was transferred for evaluation of large left bullae at risk for rupture. CT and history confirmed an interesting cause for the air pockets: marijuana, tobacco, and cocaine use.

Diagnosis and treatment of exercise-induced bronchospasm: A review

Matthew A. Stack, MA, MS, PA-C, Ahmad Hakemi, MD June 01, 2011

Exercise-induced bronchospasm is common but may often be unrecognized. The disorder  is usually responsive to treatment once the diagnosis has been made.

Polycythemia rubra vera: An unlikely cause of severe pulmonary embolism

Rami N. Khouzam, MD, FACC, FACP, FASNC, Mary Jane Gallahan, PA-C, PhD? May 30, 2011

An elderly woman presented with mild pain in her leg and shortness of breath. The results of CT and laboratory testing led to the diagnosis of a rare myeloproliferative disorder.

A female patient with shortness of breath at rest and fluid retention

Cynthia Cawley, PA-C, MPM, Srinivas Murali, MD January 28, 2011

A patient with a history significant for pulmonary arterial hypertension presents with shortness of breath and jugular venous distention.

A 52-year-old woman reports right upper quadrant pain, weakness, and fever

Kishore Kuppasani, MS, MPA, PA-C, Smita Mahendrakar, MD January 28, 2011

Wide-ranging symptoms were difficult to connect until a leaky basement provided the telltale clue.

Carpal tunel syndrome and pulmonary embolus

Dawn Colomb-Lippa, MHS, PA-C, Steve Wilson, PA-C, DFAAPA, FAPACVS January 20, 2011

Clinical features, diagnosis, and treatment of carpal tunnel syndrome and pulmonary embolus are discussed.

A Day in the Life: Nicole Larson, MPAS, PA-C

Nicole Larson, MPAS, PA-C October 19, 2010

A PA who practices in thoracic surgery describes a busy day in the hospital and the clinic.

Rapid sequence intubation: Stay up to date on this important procedure

Scott Light, PA-C August 13, 2010

The ability to perform intubation is increasingly required by emergency room physicians, internists, PAs, and paramedics.

Acute pancreatitis and croup

Dawn Colomb-Lippa, MHS, PA-C, Amy M. Klingler, MS, PA-C July 22, 2010

The general features, diagnostic criteria, and treatment modalities for acute pancreatitis and croup are reviewed.

Urinary antigen test cannot be effective in patients with renal failure

June 30, 2010

QRS: Community-acquired pneumonia (CAP) in adults

Venous thromboembolism (VTE) risk assessment improves compliance with recommended prophylaxis

Marc Moote, MS, PA-C; Michael Englesbe, MD; Vinita Bahl, DMD, MPP; Hsou Mei Hu, MBA, MHS, PhD; Maureen Thompson, MSN, RN; James Kubus, MS; Darrell Campbell Jr, MD June 11, 2010

The consistency of PA-driven care was utilized to develop a protocol for assessing risk of VTE for surgical patients, which led to significant improvement in compliance with published guidelines.

Worsening head pain and neurologic symptoms

Heidi Menga, PA-C May 24, 2010

The symptoms were concentrated in the patient's head and scalp, but the diagnosis involved a different and unexpected location.

A rare combination of uveitis, salivary gland swelling, and cranial nerve palsy in a febrile woman

Jason Evanchan, DO; Timothy J. Barreiro, DO, FCCP, FACOI; David Gemmel, PhD May 17, 2010

Bilateral swollen parotid glands trigger an evaluation and imaging studies that uncover ocular, neurologic, and pulmonary abnormalities.

A practical guide for mechanical ventilation in adult patients who require respiratory assistance

Richard G. Winters, MSPAS, PA-C; Donald A. Reiff, MD May 10, 2010

Providing care for postoperative, acutely ill, or traumatically injured patients requires an understanding of mechanical ventilation.

An immigrant with fever, chills, and pleural effusion

Navdeep Brar, MD, Aleksander Shalshin, MD December 15, 2009

This disease is uncommon in persons born in United States, but those caring for immigrants should consider its different manifestations.

Endovascular embolization with a vascular plug corrects a PAVM

Stephen Hu, MD; Christopher Davis, PA-C, MPAS October 19, 2009

A pulmonary arteriovenous malformation, discovered as an incidental finding on a chest CT, is corrected with a vascular plug.

Poor medication history plus slow symptom onset delays a diagnosis

Todd Wilkin, MPA, PA-C; LaDonna S. Hale, PharmD; Richard A. Claiborne, MD October 14, 2009

The best way to identify this type of adverse drug reaction is to obtain and document a complete and accurate medication history.

Cough steadily increases in severity

Michael D. Jacobson, MSHS, PA-C September 22, 2009

A student reports a progressively worsening cough that comes in spasms and is accompanied by a choking sensation and an inability to catch his breath.

Episodes of severe dyspnea

Tyson Parker, MPAS, PA-C July 17, 2009

A 73-year-old nonsmoker complains of fatigue and dyspnea so severe that he has to rest when walking from his car to his house and sit up on the edge of the bed to breathe.

Unusual vascular structures in the chest cavity

Julie Vajnar, PA-C, RT June 18, 2009

Shortness of breath and occasional chest pain signal a vascular anomaly in a middle-aged woman.

Sudden onset of substernal chest pain in a college student at rest

David F. Irvine, DHSc, RPA-C; Wilson Crone, MD, PhD June 08, 2009

Despite its name, spontaneous pneumomediastinum may be associated with a number of factors.

Managing recurrent pleural effusions with an indwelling pleural catheter

Julie M. Schrader, MPAS, PA-C; Peter F. Ferson, MD May 26, 2009

Case studies describe an alternative to repeat thoracentesis for patients who are at risk of reaccumulation of fluid in the chest cavity.

Dyspnea, cough, and fever following chemotherapy for Hodgkin lymphoma

Michele Taffaro-Neskey, PA-C May 22, 2009

A patient who was treated for Hodgkin disease develops obstructive/restrictive lung disease and a reduced ejection fraction.

QRS: Asthma

Leslie Kole, PA-C May 20, 2009

This review of asthma includes prevalence, clinical assesment, diagnosis, classification, and management of patients with the condition.

Another view of the differential for this case

Lyle W. Larson PA-C, PhD January 29, 2009

Case of the Month: Hypersensitive carotid sinus syndrome

A troubling radiograph follows a history of respiratory infection and long-term cough

Nancy Stasik PA-C, MPAS November 01, 2007

A 56-year-old white male was referred to our clinic for further evaluation of right-sided lymphadenopathy and a suspicious finding on a chest radiograph. Previously the patient had an upper respiratory infection and a resultant nonproductive cough. The cough became progressively worse and produced green-yellow sputum.

Using CT to diagnose pulmonary embolism

Julie Vajnar, PA-C, RT October 01, 2006

The patient is a 60-year-old man who presents to the emergency department with shortness of breath and tachycardia. He underwent a total hip replacement 2 weeks ago. You notice he has tachypnea. You hear a prominent second heart sound on auscultation and bibasilar rales over the lungs. The chest radiography findings are normal.

Clinical practice guidelines for managing COPD in a primary care setting

Daniel L. O'Donoghue, PhD, PA-C; Deborah A. Gerbert, PA-C; Lawrence M. Herman, MPA, PA-C; Lyle W. Larson, PhD, PA-C; Marie-Michèle Léger, MPH, PA-C; Robert McNellis, MPH, PA-C; Cynthia Ulshafer, PA-C; August 01, 2006

Chronic obstructive pulmonary disease (COPD) produces significant morbidity and mortality in countries around the world. Apart from the costs for direct patient care, COPD imposes a further burden on patients in the form of lost wages and the physical and emotional toll taken by the disease.