The APAPP Podcast

In this episode, we dive into the world of flexible bronchoscopy, featuring the Society of Advanced Bronchoscopy insights from Dr. Mateus Fernandez and Dr. Azeem Elahi, experts in interventional pulmonology. Together with our IP Chair, Rebecca Priebe, they discuss the fundamental aspects of bronchoscopy, including when to use this vital procedure and the considerations that come with it. 

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Recorded live at the APAPP Conference in Las Vegas, Brian Bizik, MS, PA-C, DFAAPA, and Heather O’Connell, PA-C, discuss how FeNO testing and methacholine challenge testing can support asthma diagnosis and management when spirometry does not provide a clear answer. They explain how fractional exhaled nitric oxide, or FeNO, offers insight into type 2 airway inflammation and may help clinicians evaluate treatment response, inhaled corticosteroid use, and potential biologic therapy options.

The conversation also explores how methacholine challenge testing measures airway hyperresponsiveness and can help confirm or rule out asthma in patients with persistent symptoms but normal or inconclusive spirometry. Brian and Heather review appropriate patient selection, test interpretation, safety considerations, and how these two diagnostic tools can work together to identify different asthma phenotypes, avoid misdiagnosis, and guide more personalized treatment decisions.

Register to join us for the 4th Annual APAPP National Conference in New Orleans in 2027. For more expert-driven pulmonary education, visit the Pulm Hub and APAPP ACE app.

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In this APAPP session, Molly Jozefowski, MS, PA-C, discusses the diagnosis and management of pleural effusions. She explains how fluid can accumulate in the pleural space when production increases, resorption decreases, or both processes occur. Molly also reviews how Light’s criteria help distinguish transudative from exudative pleural effusions and highlights common causes, including heart, liver, or kidney failure, malignancy, postoperative changes, and medication reactions. She also describes common symptoms such as shortness of breath, cough, and chest pressure, which may develop gradually as fluid accumulates.

This video explores how chest X-rays, CT scans, and bedside ultrasound can be used to evaluate pleural fluid, with ultrasound offering a radiation-free way to assess the size of an effusion and identify a safe drainage site. Molly reviews treatment options including diuretics, thoracentesis, tunneled pleural catheters, and pleurodesis for recurrent or malignant pleural effusions. Ideal for pulmonology providers, advanced practice providers, and clinicians involved in pleural disease management, this discussion emphasizes shared decision-making and individualized treatment based on each patient’s symptoms, goals, and clinical needs.

Register to join us for the 4th Annual APAPP National Conference in New Orleans in 2027. For more expert-driven pulmonary education, visit the Pulm Hub and APAPP ACE app.

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In this APAPP podcast, Rebecca Ezell, NP, is joined by James McNutt, NP, for a practical discussion on environmental triggers and reactive airway disease. Recapping their 2026 APAPP presentation, Rebecca and James review the global burden of asthma and COPD, the disparities faced by patients in both pollution-heavy urban areas and rural agricultural communities, and how fine particulate matter and diesel exhaust penetrate the airway mucosa to drive oxidative stress, type 2 inflammation, mucus production, and impaired repair pathways.

They also share practical strategies pulmonary advanced practice providers can use right away: environmental and occupational exposure screening, HEPA filtration, mask use at work, peak flow journaling to identify exposure patterns, addressing gas stoves, wood smoke, candles, carpet, secondhand smoke, and post-hurricane mold, and writing letters on a patient's behalf for housing accommodations. Tune in for key clinical insights on whole-patient assessment, allergy testing and referral, patient buy-in, and reducing medication burden by controlling the environment.

Register to join us for the 4th Annual APAPP National Conference in New Orleans in 2027. For more expert-driven pulmonary education, visit the Pulm Hub and APAPP ACE app.

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In this APAPP podcast, Kaitlyn Chapin, APRN, AGPCNP-BC, MSN, is joined by Sara Evans, MS, PA-C, discuss metabolic syndrome in patients with advanced lung disease and those undergoing lung transplantation. They review the key components of metabolic syndrome, including central obesity, impaired glucose metabolism, hypertension, elevated triglycerides, and reduced HDL cholesterol, while examining how these interconnected conditions may contribute to cardiovascular disease, diabetes, reduced lung function, and increased mortality.

This video explores metabolic syndrome screening and management before and after lung transplantation, including the limitations of BMI as a measure of body composition, the impact of obesity and sarcopenia on transplant candidacy, and the challenges of achieving weight loss in patients with severe respiratory limitations. Kaitlyn and Sara also discuss GLP-1 therapies, the metabolic effects of post-transplant immunosuppressive medications, and the importance of addressing cardiometabolic risk factors early and collectively. Ideal for pulmonology, advanced lung disease, and transplant providers, this discussion offers practical perspectives on improving long-term survival and quality of life for lung transplant patients.

Register to join us for the 4th Annual APAPP National Conference in New Orleans in 2027. For more expert-driven pulmonary education, visit the Pulm Hub and APAPP ACE app.

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In this APAPP FAQ, Jessica Glennie, CNP, discusses what drives fibrotic disease progression in idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF). Jessica explains how repeated microinjuries to the alveolar epithelial cells can disrupt the lungs’ natural repair process, triggering the release of profibrotic growth factors and cytokines. These signals recruit fibroblasts, promote their transformation into myofibroblasts, and lead to excessive collagen deposition and extracellular matrix production.

This video reviews the abnormal tissue and vascular remodeling that contributes to progressive lung scarring, reduced lung function, and potential pulmonary hypertension. Jessica also explains key differences between IPF and PPF, including the role inflammation may play in some forms of PPF, and discusses genetic factors associated with pulmonary fibrosis, including short telomeres and mutations involving TERT, TERC, MUC5B, and TOLLIP. Ideal for pulmonology providers, interstitial lung disease specialists, and advanced practice providers, this FAQ provides a concise overview of the biological and genetic mechanisms that contribute to pulmonary fibrosis progression.

Register to join us for the 4th Annual APAPP National Conference in New Orleans in 2027. For more expert-driven pulmonary education, visit the Pulm Hub and APAPP ACE app.

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In this APAPP podcast, Caroline Church, MSN, RN, CPNP-PC, moderates a pro-con debate on the social determinants of health in lung transplant, featuring Meg Fregoso, NP, and Elizabeth Olsen, NP. Recorded live at the 2026 APAPP conference in Las Vegas, the discussion explores the role of social determinants of health in lung transplantation through a pro-and-con debate. They examine how nonmedical factors—including financial stability, healthcare access, health literacy, housing, transportation, caregiver support, and mental health—can influence transplant eligibility, adherence, follow-up care, and long-term outcomes.

This video considers the difficult balance between responsible organ allocation and equitable access to lifesaving lung transplant care. The speakers discuss strategies for addressing modifiable barriers through patient and caregiver education, medication assistance, fundraising resources, telehealth, mental health screening, and multidisciplinary support. They also explore how these decisions may differ in pediatric transplantation, where social circumstances are often outside the child’s control. Ideal for pulmonology and transplant providers, advanced practice providers, and multidisciplinary transplant teams, this discussion offers practical perspectives on supporting patients while navigating complex transplant selection decisions.

Register to join us for the 4th Annual APAPP National Conference in New Orleans in 2027. For more expert-driven pulmonary education, visit the Pulm Hub and APAPP ACE app.

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In this APAPP podcast, Brian Bizik, MS, PA-C, DFAAPA is joined by Justine Sicari, CRNP, to recap their COPD Bootcamp presented live at the 2026 APAPP National Conference in Las Vegas. The session reviews the 2026 GOLD guideline updates and their central focus on reducing exacerbations, along with the concept of disease activity and how multiple comorbidities and precision medicine shape whole-patient COPD care.

Brian and Justine also address what comes next when a patient on optimized inhaler therapy is adherent and has completed pulmonary rehab. They discuss GOLD's exacerbation pathway, the significance of one or more exacerbations in the past year, the role of type 2 inflammation in COPD, and emerging step-up options including chronic azithromycin and the biologics now approved for COPD. Tune in for key clinical insights on early intervention, identifying candidates for step-up therapy, and the expanding treatment landscape in COPD. 

Register to join us for the 2027 APAPP National Conference in New Orleans. For more expert-driven pulmonary education, visit the Pulm Hub and the APAPP ACE app.

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In this APAPP FAQ, Jessica Glennie, CNP, answers a common question from pulmonary advanced practice providers of what the shared underlying biology of fibrosis is and what are the similarities and key distinctions in how IPF and PPF are diagnosed. Jessica starts by clarifying a frequent point of confusion—idiopathic pulmonary fibrosis is a specific diagnosis under the interstitial lung disease umbrella, while progressive pulmonary fibrosis is not a diagnosis at all, but a behavior seen in fibrotic ILDs other than IPF.

Jessica walks through each pathway: diagnosing IPF requires a usual interstitial pneumonia (UIP) pattern on high-resolution CT or biopsy plus a detailed history that excludes drug toxicity, autoimmune disease, and occupational or environmental exposures. Diagnosing PPF applies to patients with an established non-IPF cause—hypersensitivity pneumonitis, silicosis, rheumatoid arthritis, scleroderma, or drug-induced fibrosis—and requires meeting two of three ATS criteria within the past year: worsening respiratory symptoms, physiologic decline (an FVC drop of ≥5% or DLCO drop of ≥10%), or radiologic progression such as increasing honeycombing and traction bronchiectasis. Tune in for key clinical insights on distinguishing IPF from progressive pulmonary fibrosis and applying the criteria in practice. 

Register to join us for the 4th Annual APAPP National Conference in New Orleans in 2027. For more expert-driven pulmonary education, visit the Pulm Hub and APAPP ACE app.

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In this episode, Corinne Young engages with Jason Dean, a nurse practitioner specializing in restrictive thoracic disorders, to delve into the complexities of non-invasive ventilation (NIV) for patients, particularly those with COPD and neuromuscular conditions.

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