The APAPP Podcast

After listening to bronchoscopy 101, dive even deeper into the world of 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 advanced bronchoscopy procedures and techniques. 

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Recorded live in Las Vegas, Lori Reed, NP, and Rachel Merling, MSN, APN, AGACNP-BC, FNP-BC, of Pulmonary Associates discuss pulmonary hypertension for general pulmonology and sleep medicine providers. They explain how narrowing and stiffening of the pulmonary arteries increase strain on the right side of the heart, potentially leading to right-sided heart failure, and highlight common warning signs such as unexplained shortness of breath, fatigue, edema, and symptoms that seem out of proportion to COPD or interstitial lung disease.

The conversation also reviews key pulmonary hypertension risk factors and diagnostic tools, including echocardiography, BNP or NT-proBNP testing, ventilation-perfusion scans, pulmonary function testing, and right heart catheterization. Through real-world patient cases, Lori and Rachel demonstrate how recognizing subtle symptoms, investigating when treatment is not working as expected, and referring patients early can lead to the right diagnosis, more appropriate treatment, and improved outcomes.

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 educational video, Leah Fingerman, NP, an interstitial lung disease (ILD) specialist at Emory Pulmonary, explores the three key drivers of pulmonary fibrogenesis and the underlying mechanisms contributing to the development and progression of pulmonary fibrosis. She discusses how repetitive injury to the alveolar epithelium, abnormal fibroblast activation, and genetic predisposition contribute to progressive lung scarring, impaired oxygen exchange, and declining pulmonary function. Leah highlights common environmental risk factors, including cigarette smoking, occupational exposures, air pollution, chronic aspiration, and potential viral triggers, while explaining how persistent fibroblast activation and excessive collagen production create a self-perpetuating cycle of lung fibrosis. She also examines the role of genetic mutations, including MUC5B, TERT, TERC, and other telomere-related genes, in influencing disease susceptibility and progression. With a focus on short telomere syndrome, Leah discusses its association with accelerated forced vital capacity (FVC) decline, poorer clinical outcomes, increased risks associated with immunosuppressive therapy, and complications following lung transplantation. This discussion provides pulmonologists, nurse practitioners, physician assistants, and other healthcare professionals with valuable insights into the pathophysiology of pulmonary fibrosis, genetic risk factors, and the clinical implications of progressive fibrotic interstitial lung disease. Visit the PulmHub for more expert-led pulmonary education and resources designed to support clinical practice.

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What unmet needs remain in the diagnosis and treatment of pulmonary fibrosis? In this pulmonary education video, Leah Fingerman, a nurse practitioner at Emory Pulmonary, discusses some of the biggest challenges clinicians face when caring for patients with pulmonary fibrosis and interstitial lung disease (ILD). Many patients are not diagnosed until their disease has already progressed, making earlier detection and intervention a critical unmet need. Leah explores the potential role of improved screening tools, biomarkers, and artificial intelligence (AI) in identifying ILD earlier, predicting disease progression, guiding treatment decisions, monitoring disease activity, and detecting acute exacerbations. She also examines important gaps in pulmonary fibrosis treatment, including the limitations of current antifibrotic therapies, which can slow disease progression but do not reverse existing fibrosis. Looking ahead, new therapies that can repair damaged lung tissue, restore normal lung architecture, and address symptoms could transform care for patients with progressive pulmonary fibrosis. The discussion also highlights the need for better treatments to improve quality of life and reduce the burden of common pulmonary fibrosis symptoms, including chronic cough, shortness of breath (dyspnea), and fatigue. Watch to learn more about the future of pulmonary fibrosis diagnosis, ILD detection, antifibrotic treatment, emerging therapies, and opportunities to improve outcomes for patients living with fibrotic lung disease.

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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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Claim your 0.5 CME credits for listening to this episode here: https://forms.gle/42yHmF8UpemVhdDJA

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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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Claim your 0.5 CME credits for listening to this episode here: https://forms.gle/42yHmF8UpemVhdDJA

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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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Claim your 0.5 CME credits for listening to this episode here: https://forms.gle/42yHmF8UpemVhdDJA

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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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Claim your 0.5 CME credits for listening to this episode here: https://forms.gle/42yHmF8UpemVhdDJA

Visit our website for more APP Pulmonary, Critical Care, and Sleep Medicine content and free CMEs www.pulmapp.com

Follow us on:

• Instagram @pulmapps 
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