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Internal Medicine CME

 
 
Internal Medicine: A Clinical Update

March 15-19, 2010 (8:00am-12:15pm)
Location: Hyatt Regency Sarasota, Florida
20 AMA PRA Category 1 Credits™
20 CME Credits - ACEP AAFP ACOG
Course #SEMLA-2420100315
Price: $645.00 - $795.00

by Michael P. Goldfinger, M.D., F.A.C.P. - Jefferson Medical College, Thomas Jefferson University; Assistant Professor of Medicine; Director, Continuous Quality Improvement and Director, Peer/Mortality Review, Department of Medicine, Division of General Internal Medicine, Albert Einstein Medical Center, Philadelphia, PA; Merri L. Pendergrass, M.D., Ph.D. - Harvard Medical School; Associate Professor of Medicine; Vice President, National Practice Leader in Diabetes, Medco Health Solutions, Inc., Fort Worth, TX; Gerald W. Smetana, M.D. - Harvard Medical School; Associate Professor of Medicine; Director of CME, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA and C. Christopher Smith, M.D. - Harvard Medical School; Associate Professor of Medicine; Associate Director, Internal Medicine Residency Training Program, Associate Firm Chief, Blumgart Medical Firm, and Co-Director, Rabkin Fellowship in Medical Education, Beth Israel Deaconess Medical Center of Harvard Medical School, Boston, MA.

Learning Objectives
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NARRATIVE DESCRIPTION: Following this course, the participant should be able to develop an approach to the patient with metabolic disorders to arrive at a cost-effective diagnosis; apply a treatment plan that considers lifestyles, medications and specialty referral or monitoring needs; identify patients likely to develop complications and determine the long-term needs as well as resource management. 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.

The emphasis will be on current guidelines and evidence-based medicine, as indicated within each topic’s specific objectives. Since Internal Medicine takes a lead role in medicine in general, this course was designed for all practitioners at the level of a practicing physician to provide a review and up-date in their medical knowledge and abilities to diagnose, treat and improve patient care.

Day 1 Thyroid Nodules. Dizziness in the Primary Care Setting. Important Drug Interactions and Side Effects. Approach to the Patient with Syncope.
Day 2 Peripheral Arterial Disease (PAD) – A Primary Care Perspective. Outpatient Anticoagulation Issues – What’s Important in Primary Care? Abnormal Liver Tests: Case Studies for the Primary Care Provider. Dyslipidemia.
Day 3 Assessment of the Painful Knee in the Primary Care Setting. Assessment of the Painful Shoulder in the Primary Care Setting. Diagnosis of Primary Headache Syndromes. Treatment of Primary Headache Syndromes.
Day 4 Prevention of Type 2 Diabetes. Treatment of Hyperglycemia in Type 2 Diabetes. Preoperative Cardiac Evaluation. Preoperative Pulmonary Evaluation.
Day 5 Approach to the Patient with Hypertension. New Drugs for the Primary Care Physician: What You Need to Know. Common Thyroid Disorders. Common Endocrine Disorders.

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Internal Medicine: A Clinical Update
March 15-19, 2010
Location: Hyatt Regency Sarasota, Florida

SPECIFIC OBJECTIVES
Day 1Thyroid Nodules - Upon completion of this session, the participant should be able to:
1.Describe the incidence of thyroid nodules in the primary care setting.
2.Discuss features from history and physical examination that increase the likelihood of malignancy.
3.Outline the best diagnostic approach to a thyroid nodule.
4.Review common cytologic findings from fine needle aspirate and their clinical significance.
Dizziness in the Primary Care Setting - Upon completion of this session, the participant should be able to:
1.Differentiate between the most common causes of dizziness.
2.Distinguish between central and peripheral causes of vertigo.
3.Describe physical examination maneuvers used to diagnose and treat vertigo.
Important Drug Interactions and Side Effects - Upon completion of this session, the participant should be able to:
1.Discuss the most common mechanisms for drug interactions.
2.Identify some of the most frequent culprit drugs.
3.Counsel patients regarding some of the most frequent side-effects seen with commonly used medications.
Approach to the Patient with Syncope - Upon completion of this session, the participant should be able to:
1.Discuss the various etiologies of syncope.
2.Use clues in the history and physical as well as simple office testing to risk-stratify patients.
3.Develop a plan for appropriate use of additional testing in patients with syncope.
4.Gain an appreciation of the role of lifestyle measures, medication, and more invasive measures to prevent recurrent syncope.

Day 2Peripheral Arterial Disease (PAD) – A Primary Care Perspective - Upon completion of this session, the participant should be able to:
1.Describe the pathophysiology of arteriosclerosis, the most common cause of PAD.
2.Identify patients at increased risk for PAD.
3.Perform a focused history and physical examination to assess for PAD.
4.Have an appreciation of the role of ancillary testing.
5.Develop a plan for management of patients with PAD utilizing evidence-based guidelines for exercise, medications and revascularization.
Outpatient Anticoagulation Issues – What’s Important in Primary Care? - Upon completion of this session, the participant should be able to:
1.Manage outpatient warfarin using current guidelines.
2.Describe when and how to reverse the effects of warfarin.
3.Evaluate patients for hypercoagulable states and appreciate the implications.
4.Advise patients on the appropriate duration and intensity of anticoagulation in a variety of clinical scenarios.
Abnormal Liver Tests: Case Studies for the Primary Care Provider - Upon completion of this session, the participant should be able to:
1.Describe a diagnostic approach to assess patients with asymptomatic elevations in liver studies.
2.Describe the common causes of asymptomatic elevations in transaminase levels.
3.Review the natural history of hepatitis B infection, including serologic markers and indications for treatment.
4.Review the epidemiology, evaluation and potential treatment options for nonalcoholic steatohepatitis.
Dyslipidemia - Upon completion of this session, the participant should be able to:
1.Apply recent changes to ATP III lipid management guidelines to their clinical practice.
2.Recognize secondary causes of dyslipidemia.
3.Describe treatment strategies for various dyslipidemic states.

Day 3Assessment of the Painful Knee in a Primary Care Setting - Upon completion of this session, the participant should be able to:
1.Recognize key historical features to help distinguish between common causes of knee pain in the primary care setting.
2.Demonstrate physical examination skills utilized in the diagnosis of common causes of knee pain.
3.Describe the treatment of common knee injuries in the primary care setting and determine which injuries require orthopedic consultation.
Assessment of the Painful Shoulder in the Primary Care Setting - Upon completion of this session, the participant should be able to:
1.Review the anatomy of the shoulder in relation to common mechanisms of injury.
2.Describe and utilize key historical and physical examination skills needed to accurately diagnose common causes of shoulder pain in the primary care setting.
3.Describe the initial management of common shoulder injuries.
Diagnosis of Primary Headache Syndromes - Upon completion of this session, the participant should be able to:
1.Discuss the historical features of migraine, tension-type, and cluster headache.
2.Recognize which historical features best discriminate between migraine and tension-type headache.
3.List the triggers for migraine.
Treatment of Primary Headache Syndromes - Upon completion of this session, the participant should be able to:
1.Appreciate the role of abortive therapy for migraine, tension-type, and cluster headache.
2.Recognize the range of options for pharmacologic preventive therapy for migraine, tension-type, and cluster headache.
3.Develop non-pharmacologic treatment strategies for migraine.

Day 4Prevention of Type 2 Diabetes - Upon completion of this session, the participant should be able to:
1.Identify patients with pre-diabetes.
2.Describe recommendations of professional organizations regarding diabetes prevention.
3.Treat CVD risk factors in patients with pre-diabetes.
Treatment of Hyperglycemia in Type 2 Diabetes - Upon completion of this session, the participant should be able to:
1.Understand the glucose targets in T2DM.
2.Describe current pharmacological treatment options.
3.Develop individualized regimens to optimize glycemic control.
Preoperative Cardiac Evaluation - Upon completion of this session, the participant should be able to:
1.Develop risk stratification for perioperative cardiac risk.
2.Demonstrate knowledge of preoperative cardiac risk guidelines and the revised cardiac risk index.
3.Properly use beta-blockers and statins for patients at risk for perioperative cardiac complications.
Preoperative Pulmonary Evaluation - Upon completion of this session, the participant should be able to:
1.Identify patient and procedure-related risk factors for postoperative pulmonary complications.
2.Appreciate the limited role of preoperative spirometry.
3.Apply strategies to reduce the risk of postoperative pulmonary complications.

Day 5Approach to the Patient with Hypertension - Upon completion of this session, the participant should be able to:
1.Appreciate that all antihypertensive medications do not equally reduce cardiovascular risk.
2.Apply the JNC-7 guidelines to clinical care of hypertensive patients.
3.Recognize compelling indications for selection of initial antihypertensive therapy.
4.Identify which drugs most effectively reduce the risk of cardiovascular disease.
New Drugs for the Primary Care Physician: What You Need to Know - Upon completion of this session, the participant should be able to:
1.Survey important advances in pharmacotherapy that pertain to primary care practice.
2.Discuss the efficacy and list the side effects for each drug.
3.Compare key new drugs with previously available medications for similar indications.
Common Thyroid Disorders - Upon completion of this session, the participant should be able to:
1.Diagnose common causes of thyroid hyper-function and hypo-function.
2.Treat common thyroid function abnormalities.
3.Perform an appropriate evaluation of thyroid nodules.
Common Endocrine Disorders - Upon completion of this session, the participant should be able to:
1.Recognize, evaluate and treat common endocrine abnormalities including:
a.Hypoglycemia,
b.Hypercalcemia,
c.Low testosterone,
d.Adrenal masses.

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