Key presentations and conditions
Basic Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Presentations
- Chest pain
- Cough, chronic with or without sputum
- Dyspnoea
Conditions
- Asthma
- Bronchiectasis
- Chronic obstructive pulmonary disease (COPD)
- Pleural effusion
- Pneumonia
- Primary malignancies of the lung and pleura
- Pulmonary embolism
- Respiratory failure:
- acute
- chronic
- Sleep disorders:
- insomnia
- sleep apnoea
- other sleep-disordered breathing
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - prescribe therapies tailored to patients’ 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
Less common or more complex presentations and conditions
Basic Trainees will understand these presentations and conditions. Basic Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Conditions
- Cystic fibrosis
- Interstitial lung disease
- Lung abscess
- Lung transplantation
- Pneumothorax:
- primary
- secondary
- Pulmonary hypertension:
- primary
- secondary
- Pulmonary and pleural metastases
- Pulmonary vasculitides
- Sleep disorders:
- insomnia and poor sleep habits
- REM sleep behavioural disorder
- restless legs syndrome and periodic limb movements of sleep
- Tuberculosis
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - prescribe therapies tailored to patients’ 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
Epidemiology, pathophysiology and clinical sciences
Basic Trainees will describe the principles of the foundational sciences.
- Anatomy of the lungs and airways
- Effects of inflammation of the airways and associated diseases
- Importance of ventilation / perfusion (V / Q) matching
- Measurement of ventilation
- Mechanisms for acid–base balance
- Process of gas exchange
Investigations, procedures and clinical assessment tools
Basic Trainees will know the indications for, and how to interpret the results of these investigations, procedures, and clinical assessments tools. Basic Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Investigations
- Arterial blood gases
- Basic pulmonary function tests, such as diffusing capacity for carbon monoxide (DLCO), flow-volume loops, lung volumes, and spirometry
- Cardiopulmonary exercise tests
- Diagnostic sleep studies
- Endobronchial ultrasound (EBUS) procedures
- Imaging, such as:
- chest CT
- chest ultrasound
- chest X-ray (CXR)
- CT pulmonary angiography (CTPA)
- PET scan
- V / Q scan
- Pulse oximetry
- Six minute walk test
- Tissue biopsy, including biopsies of pleura, lung parenchyma, and lymph nodes
Procedures
- Bronchoscopy
- Intercostal catheter insertion
- Thoracentesis, with or without pleural ultrasound
Important specific issues
Basic Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
- Broader public health implications related to the investigation and management of respiratory infectious diseases, such as tuberculosis, Legionnaires disease, and pertussis
- Effects of ageing on the respiratory system
- Effects of common comorbid conditions, obesity, and metabolic syndrome on the respiratory system
- Effects of environmental toxins, such as cigarettes and asbestos on the respiratory system
- Effects of interactions between pulmonary and systemic circulation and cardiac function
- Effects of pregnancy on the respiratory system
- Effects of sleep-disordered breathing on the respiratory system and cardio-respiratory control
- End-of-life care for patients with respiratory disease
- Insomnia and good sleep habits
- Role of non-invasive ventilation in respiratory disorders, including COPD, motor neurone disease, and obesity hypoventilation
- References to patients in the remainder of this document may include their families or carers.