Geriatrics CME

Geriatrics: A Primary Care Approach to the Aging Population
February 8-12, 2010 (8:00am-12:15pm) Location: Hyatt Regency Sarasota, Florida 20 AMA PRA Category 1 Credits™ 20 CME Credits - ACEP AAFP ACOG	Course #SEMLA-2420100208 Price: $645.00 - $795.00

by Gary H. Oberlender, M.D., F.A.C.P. - Consultant in Geriatric Medicine and John W. Pendleton, M.D. - University of Virginia School of Medicine; Assistant Professor of Clinical Medicine, Roanoke-Salem Program; Chief, Rheumatology Section, Veterans Affairs Medical Center, Salem, Virginia; Staff Rheumatologist, Carilion Clinic, Carilion Roanoke Memorial Hospital, Roanoke, VA.

Learning Objectives
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NARRATIVE DESCRIPTION: Following this course, the participant should be able to identify the etiologies, epidemiologies and presenting clinical manifestations of the disorders described; implement a differential diagnosis and laboratory assessment plans; outline the therapeutic intervention, possible complications and preventive measures. This activity is expected to result in increased confidence in making an appropriate diagnosis and providing effective treatment and referral or follow-up care with the overall goal of improving patient outcomes.

When indicated in the specific objectives, emphasis will be on current guidelines and evidence-based medicine with a focus on diagnosis, treatment and when to refer. In consideration of our aging population, a physician is expected to be competent in the fundamentals of Geriatric Medicine and rely upon specialist only when absolutely necessary; therefore, this course was designed as a review and update for all practitioners at the level of a practicing physician.

Day 1 Delirium in the Elderly - Current Concepts. Osteoporosis: Contemporary Diagnosis and Treatment. Dementia in the Elderly, Parts 1 and 2.

Day 2 Advanced Nutritional Assessment and Therapy. Musculoskeletal Exam for the Primary Care Provider: Practical Tips. Vitamin B-12 Deficiency in the Elderly. Osteoarthritis: Diagnosis and Treatment in the Older Patient.

Day 3 Exercise Program in the Elderly “A Movement Whose Time Has Come”. Sensible Approaches to Geriatric Infections. Rheumatologic Lab Tests and Rheumatoid Arthritis in the Elderly. Sensible Prescribing Practices for the Elderly.

Day 4 Geriatric Depression: Advances in Diagnosis and Treatment. Treatment of Chronic Pain in the Elderly. Office Orthopedics in the Older Patient. Contemporary Issues in End of Life Care.

Day 5 Polymyalgia Rheumatica and Giant Cell Arteritis. Risk Management and Care of the Elderly. Gout and Pseudogout in the Elderly. Improving Communication Skills in Medical Practice.

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Geriatrics: A Primary Care Approach to the Aging Population
February 8-12, 2010
Location: Hyatt Regency Sarasota, Florida

SPECIFIC OBJECTIVES - The attendees of this program will be instructed on the following Geriatric issues with an emphasis on practical and useful information that may be evaluated for immediate application to their individual practice settings.

Day 1

Delirium in the Elderly - Current Concepts - Upon completion of this session, the participant should be able to:

1.	List diagnostic features and common causes of delirium.
2.	Appreciate causes of persistent delirium.
3.	Describe non-pharmacologic and pharmacologic treatment approaches to the delirious patient.
4.	Identify options to address agitation.
Osteoporosis: Contemporary Diagnosis and Treatment - Upon completion of this session, the participant should be able to:
1.	Describe the differences in the WHO, physiologic, and clinical definition of osteoporosis.
2.	Distinguish between the effects on bone metabolism of aging and those during the post-menopausal period.
3.	Recognize the limitations of using only the T-score in assessing the risk of fracture.
4.	Describe the importance of adequate vitamin D and calcium in the treatment of Osteoporosis.
Dementia in the Elderly, Parts 1 and 2 - Upon completion of this session, the participant should be able to:
1.	List common causes of dementia in the elderly and the value of objectifying cognitive performance.
2.	Describe the risks and benefits of commonly used drugs to treat dementia.
3.	Describe a reasonable medical evaluation of a newly identified patient.
4.	Recognize the value of caregiver education and support.

Day 2

Advanced Nutritional Assessment and Therapy - Upon completion of this session, the participant should be able to:

1.	Utilize readily available clinical data to make accurate and comprehensive nutritional assessments.
2.	Identify common vitamin and mineral deficiencies in seniors.
3.	Identify a range of therapeutic nutritional approaches for acutely ill, chronically ill, and frail patients.
4.	Apply nutritional therapies towards improved wellness.
Musculoskeletal Exam for the Primary Care Provider: Practical Tips - Upon completion of this session, the participant should be able to:
1.	Define the various maneuvers in the shoulder exam to detect an impingement syndrome and adhesive capsulitis.
2.	List the various causes of swelling and pain in the elbow and the maneuvers to distinguish them.
3.	Describe the location of pain and the earliest exam changes noted in arthritis of the hip.
4.	Describe the most sensitive test to detect effusions of the knee joint.
Vitamin B-12 Deficiency in the Elderly - Upon completion of this session, the participant should be able to:
1.	Describe normal B-12 physiology and the pathophysiology of B-12 deficiency and its causes.
2.	Describe the use of metabolic markers in B-12 deficiency.
3.	Define work-up of B-12 deficiency in clinical practice.
Osteoarthritis: Diagnosis and Treatment in the Older Patient - Upon completion of this session, the participant should be able to:
1.	Describe newer understandings of the pathophysiology of OA.
2.	Recognize the typical and atypical clinical features of OA.
3.	Describe the various treatments of OA and how to integrate them.
4.	Distinguish OA symptoms from those of other localized or generalized disorders.

Day 3

Exercise Program in the Elderly “A Movement Whose Time Has Come” - Upon completion of this session, the participant should be able to:

1.	Describe the relationship between maximal oxygen consumption, aging, and functional status.
2.	List the potential benefits of exercise.
3.	Describe the risks of exercise and how to minimize them.
4.	List the components of an exercise program.
Sensible Approaches to Geriatric Infections - Upon completion of this session, the participant should be able to:
1.	Describe atypical presentation of infectious illness in the elderly.
2.	Identify causes of pneumonia and UTI and describe the approach to antibiotic selection.
3.	Describe considerations in emerging antibiotic resistance.
4.	Describe options in the prevention and treatment of antibiotic associated diarrhea.
Rheumatologic Lab Tests and Rheumatoid Arthritis in the Elderly - Upon completion of this session, the participant should be able to:
1.	Describe the impact of aging on the sensitivity and specificity of rheumatologic lab tests.
2.	Describe the alterations in the presentation of rheumatoid arthritis in the elderly.
3.	Describe use of corticosteroids in elderly onset rheumatoid arthritis.
4.	Describe clinical factors that predict progressive and destructive rheumatoid arthritis.
5.	Describe the ADRs of biologic treatments in RA.
Sensible Prescribing Practices for the Elderly - Upon completion of this session, the participant should be able to:
1.	Recognize the limits of studies on drug safety and efficacy as they apply to the elderly.
2.	Appreciate the subtle but significant drug side effects in the elderly.
3.	Describe undesirable prescribing practices and better approaches.

Day 4

Geriatric Depression: Advances in Diagnosis and Treatment - Upon completion of this session, the participant should be able to:

1.	Describe the variety of clinical presentations of depressive syndromes in the elderly.
2.	Discuss the utility and application of the Geriatric Depression Scale.
3.	Identify the relative advantages and disadvantages of the various medications available for treatment of depression.
4.	Recognize the role of nutritional supplementation and non-pharmacologic treatments in conjunction with medical treatments.
Treatment of Chronic Pain in the Elderly - Upon completion of this session, the participant should be able to:
1.	List the adverse effects of NSAIDs in the elderly.
2.	Describe the alterations in the central peripheral nervous system that can lead to chronic pain.
3.	Describe the ADRs associated with opiate use in the elderly.
Office Orthopedics in the Older Patient - Upon completion of this session, the participant should be able to:
1.	List the common causes of acute low back pain in the elderly.
2.	Describe the symptoms and treatment of spinal stenosis.
3.	List the common causes of neck pain in the elderly.
Contemporary Issues in End of Life Care - Upon Completion of this session, the participant should be able to:
1.	Describe a practical approach to assessment of the whole patient in a hospice setting.
2.	Describe effective approaches to common physical symptoms in the terminally ill.
3.	Describe effective clinical care of patients and their families in the last days of life.
4.	Describe dementia as a terminal illness.

Day 5

Polymyalgia Rheumatica and Giant Cell Arteritis - Upon completion of this session, the participant should be able to:

1.	Describe the typical symptoms, physical findings, and laboratory abnormalities in polymyalgia rheumatica.
2.	Describe the best prednisone doses as initial treatment of PMR.
3.	Describe the typical and atypical presentations of GCA.
4.	Describe the appropriate indication and technique for temporal artery biopsy.
5.	Describe the most effective treatment and the most serious complications of GCA.
Risk Management and Care of the Elderly - Upon completion of this session, the participant should be able to:
1.	Define basic principles of effective risk management practices.
2.	Identify newer concepts and approaches in dealing with medical errors.
3.	Describe the benefits of honest disclosure of medical errors.
Gout and Pseudogout in the Elderly - Upon completion of this session, the participant should be able to:
1.	Recognize the unique characteristics of gout in the elderly.
2.	Define the factors in the elderly that impact the presentation and treatment of gout.
3.	Describe the clinical manifestations of calcium pyrophosphate deposition.
4.	Describe the polarized microscopic findings for uric acid and CPPD crystals.
Improving Communication Skills in Medical Practice - Upon Completion of this session, the participant should be able to:
1.	Describe the variety of ways that people perceive communication and process information.
2.	Identify your personal communication strengths and limitations.
3.	Describe communication issues unique to older patients.
4.	Describe practices to maximize effective communication and listening.

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