PULMONOLOGIST is a doctor who has special training in diagnosing and treating diseases of the lungs
Pulmonology is considered a branch of medicine, and Pulmonology often involves managing patients who need life support and mechanical ventilation. Pulmonologists are specially trained in diseases and conditions of the chest, particularly pneumonia, asthma, tuberculosis, emphysema,
Although pulmonary medicine only began to evolve as a medical specialty in the 1950s, William Welch and William Osler founded the ‘parent’ organization of the American Thoracic Society. the National Association for the Study and Prevention of Tuberculosis.
The care, treatment, and study of tuberculosis of the lung is recognised as a discipline in its own right, phthisiology. When the specialty did begin to evolve, several discoveries were being made linking the respiratory system and the measurement of arterial blood gases, attracting more and more physicians and researchers to the developing field complicated chest infections
Interventional pulmonology is a relatively new field within pulmonary medicine that deals with the use of procedures such as bronchoscopy and pleuroscopy to treat several pulmonary diseases. Interventional pulmonology is increasingly recognized as a specific medical specialty.
The pulmonologist begins the diagnostic process with a general review focusing on:
- hereditarydiseases affecting the lungs (cystic fibrosis alpha 1-antitrypsin deficiency)
- exposure to toxicants(tobacco smoke, asbestos, exhaust fumes, coal mining fumes, e-cigarette aerosol,)
- exposure to infectious agents(certain types of birds, malt processing)
- an autoimmunediathesis that might predispose to certain conditions (pulmonary fibrosis, pulmonary hypertension)
Physical diagnostics are as important as in other fields of medicine.
- Inspection of the hands for signs of cyanosisor clubbing, chest wall, and respiratory rate.
- Palpation of the cervical lymph nodes, tracheaand chest wall movement.
- Percussionof the lung fields for dullness or hyper-resonance.
- Auscultation(with a stethoscope) of the lung fields for diminished or unusual breath sounds.
- Ralesor rhonchi heard over lung fields with a stethoscope.
Clinical procedures
Pulmonary clinical procedures include the following pulmonary tests and procedures:[21][22]
- Medical laboratoryinvestigation of blood (blood tests). Sometimes arterial blood gas tests are also required.
- Spirometrythe determination of maximum airflow at a given lung volume as measured by breathing into a dedicated machine; this is the key test to diagnose airflow obstruction.
- Pulmonary function testingincluding spirometry, as above, plus response to bronchodilators, lung volumes, and diffusion capacity, the latter being a measure of lung oxygen absorptive area
- Bronchoscopywith bronchoalveolar lavage (BAL), endobronchial and transbronchial biopsy and epithelial brushing
- Chest X-rays
- CT scan
- Scintigraphyand other methods of nuclear medicine
- Positron emission tomography(especially in lung cancer)
- Polysomnography(sleep studies) commonly used for the diagnosis of sleep apnea
