Presentations
- Acute respiratory distress syndrome (ARDS)
- Chest pain
- Cough
- Fever
- Shortness of breath
Conditions
- Pulmonary manifestations of cystic fibrosis
Acute lung injury
- Barotrauma
- Chest trauma
- Drug-induced injury / disease (including illicit drugs)
- Other inhalation injuries (e.g., EVALI)
- Radiation
- Thermal – smoke inhalation and burns
Infections
- Community acquired pneumonia (CAP)
- Extra-pulmonary tuberculosis (TB)
- HIV / AIDS
- Latent TB infection
- Lung abscess:
- cryptococcal disease
- fungal infection
- other
- Mycoplasma and other atypical infections (e.g., Legionella)
- Non-tuberculous mycobacterial diseases
- Nosocomial pneumonia
- Para-pneumonic effusion and empyema
- Parasitic infection:
- ascaris
- echinococcus
- strongyloides
- Pertussis
- Pulmonary TB
- TB in the immunocompromised host
- Upper and lower respiratory tract infections
- Ventilator-associated pneumonia
- Viral infection (including epidemic e.g., influenza, SARS, COVID), RSV
Neonatal conditions
- Bronchopulmonary dysplasia / Chronic lung disease of prematurity
- Hyaline membrane disease
- Meconium aspiration
- Pulmonary interstitial emphysema
- Surfactant protein deficiency
- Transient tachypnoea of newborn
Pleural disease
- Chylothorax
- Empyema
- Haemothorax
- Pleural effusions
- Pneumothorax:
Thoracic lesions, nodules, and masses
- Benign tumours
- Congenital malformations of the lower respiratory tract and lungs
- Malignant (primary, secondary, and metastatic)
- Mediastinal cysts and tumours
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored tpatients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Conditions
- Cardiovascular disease that affects the lung:
- congenital heart disease
- pulmonary hypertension
- pulmonary oedema
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored tpatients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Anatomical relationships of pulmonary structures and congenital defects
- Current classifications of congenital pulmonary airway malformation and management issues (e.g., potential association with lung malignancy)
- Knowledge of other congenital lung malformation, including bronchopulmonary sequestration, bronchial atresia, and congenital lobar emphysema
- Liaison with neurodevelopmental services
- Management:
- acute management principles
- options for long-term care, particularly:
- home oxygen
- identification of other sequelae
- nutrition
- options for patent ductus arteriosus (PDA) management
- role and use of surfactant
- role of steroids and diuretics
- ventilation strategies, including high frequency oscillation (HFO) and extracorporeal membrane oxygenation (ECMO)
- use of nitric oxide (NO) and other strategies in the management of pulmonary hypertension
Approach
- Age-appropriate differential diagnosis of infective causes, including newborn, preschool, and school-aged child
- Differential diagnosis of non-infective causes
- Management:
- investigation and management of acute, recurrent, persistent, and atypical pneumonia
- long-term sequelae of RSV, adenovirus, mycoplasma, and bronchiolitis obliterans
- management options for allergic bronchopulmonary aspergillosis (ABPA)
- public health issues, including infection control guidelines, cohorting, smoking / vaping prevention and cessation, and climate change mitigation strategies
- relevant microbiology and choice of appropriate antibiotics
- role of immunological investigations
- the investigation and management of typical versus atypical croup
- treatment of community- and hospital-acquired pulmonary infections, including ventilator-associated pneumonia
- vaccination
Investigations
- Blood tests:
- blood count and inflammatory markers
- blood cultures
- blood tests to identify potential infectious source (e.g., pneumonia serology, strep, and TB)
- screening tests for potential underlying primary immunodeficiency
- sterile site PCR (e.g., blood, CSF, and pleural fluid)
- Investigations of pleural fluid / sputum / bronchoalveolar lavage, including microbiome investigation
- Radiological tests:
- chest CT scan
- chest x-ray
- nuclear studies
Procedures
- Home oxygen prescription
- Identification and utilisation of community services and support (NDIS and other government funding facility for equipment)
- Insertion of chest drains
- Interpretation of blood gases
- Interpretation of radiological investigations
- Ventilation – invasive and non-invasive ventilation strategies
- Appropriate timing to involve ENT and thoracic surgeons
- Identification and management of congenital malformations in the context of a child with a syndrome
- Impact of climate change on respiratory health, including:
- directly promoting or aggravating respiratory disease, such as asthma and respiratory infections
- increasing exposure to risk factors for respiratory diseases, such as chemical air pollutants and effect on aeroallergens
- Management of empyema, including administration of thrombolytics / fibrinolytics or appropriate referral for surgical intervention
- Management of TB in the immunocompromised host
- Occupational health and safety issues for staff treating patients with HIV / AIDS or TB
- Relevant public health legislation
- Role of flexible bronchoscopy / bronchoalveolar lavage
- Role of TB clinics, including contact tracing and screening
- Ventilatory strategies for congenital malformations / congenital diaphragmatic hernia
