Past History ILD risk factors Other Presenting History Symptom duration Dyspnoea Cough Other Systemic symptoms Symptom progression Pattern improving stable relapsingremitting worsening ID: 909710
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Slide1
Management to
date and response
Past History
ILD risk factors:
Other
:
Presenting HistorySymptom duration: Dyspnoea: Cough: Other: Systemic symptoms: Symptom progressionPattern: [improving, stable, relapsing/remitting, worsening]Current status:WHO class: ILD comorbidities: [hypoxic resp failure, pulmonary hypertension]
ExposuresJob duties: Environment: Smoking: Medications: Family history ILD[Present/absent]
Investigation findingsSerologyANA: ENA: ACCP/RF: Other:
[date][date][date]Absolute change (%pr)L%prL%prL%prFEV1FVCDLCO
Serial lung function
Six minute walk test
[date][date][date]DistanceResting O2 satNadir O2 sat
Examination findingsOxygen saturation: Chest findings: [extent of crackles, other]Extra-pulmonary findings: [Connective tissue disease features, other]Comorbidities: [pulmonary BP, RHF, other] Other findings:
HRCT dates: BAL date: BAL pattern: Histology type and date: Other results: [PASP, AHI]
Slide 1
ILD MDM Toolkit
Single Clinical Slide Format – Alfred Hospital, Melbourne
Name:
Age:
Sex:
Slide2Research terminology
Acronym
Interstitial pneumonia with autoimmune features IPAFCombined
pulmonary fibrosis and emphysemaCPFEFamilial interstitial lung disease
Smoking related interstitial lung disease
Common diagnostic termsAcronymIdiopathic pulmonary fibrosisIPF
Non-specific interstitial pneumonitisNSIPCryptogenic organising pneumoniaCOPDesquamative interstitial pneumonia
DIPRespiratory bronchiolitis-interstitial lung diseaseRB-ILDPleuro-parenchymal fibroelastosisPPFELymphoid interstitial pneumoniaLIPAcute interstitial pneumoniaAIPUnclassifiable interstitial pneumonia, [state if provisional]Connective tissue disease related interstitial lung disease, [include histological subtype & connective tissue disease]CTD-ILDHypersensitivity pneumonitis [acute, chronic][A/C]HPEosinophilic pneumonia [acute, chronic][A/C]EPLangerhans cell histiocytosisLCH
Pulmonary lymphangioleiomyomatosis PLAMDisease behaviourReversible and self-limitedReversible disease with risk of progressionStable with residual diseaseProgressive, irreversible disease with potential for stabilizationProgressive, irreversible disease despite therapy
Diagnostic confidenceLikelihoodConfident≥90%Provisional, high confidence70-89%
Provisional, low confidence51-69%Unclassifiable ILD≤50%Suggested Therapeutic GoalAchieve regressionMaintain statusSlow progressionPalliative/best supportive careCommon diagnostic terms (cont.)AcronymSarcoidosis, [specify organ involvement]Dust induced disease, [specify dust]Drug induced lung disease, [specify drug]Pulmonary vasculitis, [specify subtype]Pulmonary alveolar proteinosisPrimary pulmonary haemosiderosisPrimary alveolar microlithiasisSlide 2ILD MDM ToolkitSingle Clinical Slide Format – Alfred Hospital, Melbourne
Slide3CURRENT CLINICAL TRIALS AND RESEARCH
Project name
1234
Agent
Duration
ComparatorKey inclusion criteria
Key exclusion criteriaPrimary endpointNumber participants soughtScreened
EnrolledNotesContact personSlide 3ILD MDM ToolkitSingle Clinical Slide Format – Alfred Hospital, Melbourne