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Diagnosis and Treatment of Combined Pulmonary Fibrosis and Emphysema in 2022

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Chronic obstructive pulmonary disease (COPD) affects an estimated 6.4% and interstitial lung disease (ILD) affects an estimated 0.3% of adults in the US. COPD is defined by airflow obstruction on spirometry, as indicated by a low ratio of forced expiratory volume in the first second to forced vital capacity. Emphysema and chronic bronchitis are the main processes underlying airflow obstruction in COPD. Emphysema is visualized on chest computed tomography (CT) as foci of decreased lung attenuation due to alveolar tissue loss and results in increased lung compliance and volume (hyperinflation). In contrast, most ILDs cause fibroinflammatory parenchymal infiltration that reduces lung compliance and volumes, resulting in a restrictive ventilatory defect on pulmonary function testing. CT findings that indicate ILD include ground-glass/reticular opacities, traction bronchiectasis/bronchiolectasis, or honeycombing.

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Article Information

Corresponding Author: Jay H. Ryu, MD, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (ryu.jay@mayo.edu).

Conflict of Interest Disclosures: None reported.

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Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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