ABIM Pulmonary study plan

Build a stepwise arterial blood gas interpretation worksheet that classifies primary acid-base disorders, calculates compensation and the anion gap, and flags mixed pictures in under three minutes per case.

Distinguish the four Berlin ARDS severity strata and select tidal volume, plateau pressure, and PEEP targets for each, including indications for prone positioning and neuromuscular blockade.

Compare pressure-, volume-, and pressure-regulated volume-control modes on the parameters each guarantees, and predict the hemodynamic consequence of rising intrathoracic pressure.

Formulate a differential and initial ventilator strategy for the four canonical failure patterns: obstructive shock-adjacent auto-PEEP, flash pulmonary edema, massive PE, and neuromuscular hypoventilation.

Rehearse liberation from mechanical ventilation by applying rapid-shallow-breathing, cuff-leak, and sedation-interruption criteria to written vignettes.

Stage airflow obstruction using post-bronchodilator spirometry against fixed and lower-limit-of-normal thresholds, and explain why the FEV1/FVC ratio falls with age.

Match each of the four GOLD symptom-and-exacerbation groups to an inhaled regimen, and justify when triple therapy, roflumilast, or azithromycin is added.

Differentiate asthma from COPD in a smoker with reversibility, then specify the phenotype features (eosinophils, FeNO, exacerbation frequency) that change biologic or inhaled corticosteroid decisions.

Interpret lung volumes, diffusing capacity, and high-resolution imaging to separate emphysema-predominant from airway-predominant disease, and identify candidates for lung volume reduction.

Outline the recognition and management of acute exacerbation, including noninvasive ventilation triggers, corticosteroid duration, and antibiotic indications.

Classify interstitial lung disease by pattern on high-resolution CT, and state which patterns permit a confident clinical diagnosis without surgical biopsy.

Apply the current diagnostic criteria for idiopathic pulmonary fibrosis, including the significance of usual interstitial pneumonia pattern, honeycombing, and alternate diagnoses.

Differentiate the major connective tissue disease-associated and exposure-related interstitial diseases by serologies, extrapulmonary findings, and occupational or drug history.

Select antifibrotic, immunosuppressive, or observation-only management by disease subtype, and identify the triggers that should prompt transplant referral.

Recognize acute exacerbation of fibrotic disease and distinguish it from infection, fluid overload, and drug toxicity in a deteriorating patient.

Risk-stratify acute pulmonary embolism using clinical probability tools, age-adjusted D-dimer thresholds, and ventricular strain or troponin markers to choose between anticoagulation, catheter therapy, and systemic thrombolysis.

Compare direct oral anticoagulants with warfarin and low-molecular-weight heparin across provoked, cancer-associated, antiphospholipid, and pregnancy-related embolism, including duration of therapy.

Diagnose chronic thromboembolic pulmonary hypertension by integrating ventilation-perfusion imaging, echocardiographic estimates, and right heart catheterization, and identify surgical candidacy.

Work through the World Health Organization group classification of pulmonary hypertension and match each group to its definitive diagnostic test.

Interpret right heart catheterization hemodynamics to separate precapillary from postcapillary disease and calculate pulmonary vascular resistance.

Stage non-small cell lung cancer using tumor-node-metastasis descriptors and select the imaging and mediastinal sampling strategy that matches each stage.

Correlate molecular and immune markers with first-line therapy choice, and explain when tissue rebiopsy at progression is required.

Distinguish small cell lung cancer management by limited versus extensive stage, including prophylactic cranial irradiation indications.

Evaluate a solitary pulmonary nodule using size, morphology, and validated malignancy probability models to choose surveillance intervals versus biopsy or resection.

Select empiric regimens for community-acquired pneumonia by severity and comorbidity, and apply severity scores to decide inpatient versus intensive care admission.

Differentiate the classic opportunistic pneumonias in immunocompromised hosts by imaging pattern, antigen testing, and induced-sputum or bronchoalveolar lavage findings.

Manage tuberculosis across latent, drug-susceptible, and drug-resistant scenarios, including isolation criteria and hepatotoxicity monitoring.

Classify pleural effusions by Light criteria and transudative versus exudative causes, then order the next three tests that most often change management.

Interpret pleural fluid pH, glucose, adenosine deaminase, and cytology in the settings of parapneumonic effusion, empyema, and malignancy.

Plan initial chest tube or indwelling catheter management for pneumothorax and complicated parapneumonic effusion, including failure criteria and surgical escalation.

Score and stage obstructive sleep apnea from polysomnography or home testing, and match positive airway pressure settings to the titration study.

Identify central sleep apnea, obesity hypoventilation, and sleep-related hypoventilation by blood gas and nocturnal oximetry patterns, and select non-positive-airway-pressure therapies.

Counsel on sleep apnea consequences and adherence barriers, and document clearance-to-drive and perioperative risk considerations.

Differentiate pneumoconioses by exposure history and radiographic pattern, including silicosis, coal worker disease, and asbestos-related pleural and parenchymal disease.

Recognize occupational asthma, hypersensitivity pneumonitis, and building-related illness by temporal pattern and exposure documentation, and describe the regulatory surveillance framework.

Differentiate neuromuscular and chest wall causes of hypoventilation using vital capacity, maximal inspiratory pressure, and carbon dioxide trends, and time noninvasive ventilation initiation.

Recognize presentations of myasthenia gravis, Guillain-Barre syndrome, amyotrophic lateral sclerosis, and muscular dystrophy relevant to respiratory failure and secretion clearance.

Assess kyphoscoliosis and obesity-related restrictive physiology and predict which patients fail extubation.

Integrate the highest-yield concepts from all ten domains by re-testing every missed item from weeks one through seven.

Simulate a timed 60-question mixed-domain block and convert the score into a two-week remediation list.