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by Laurence J. Kinsella, M.D., F.A.A.N. - Saint Louis University Medical School; Professor of Neurology; Chief, Division of Neurology and Neurophysiology, Forest Park Hospital, St. Louis, MO and David E. Riley, M.D. - Case Western Reserve University School of Medicine; Professor, Department of Neurology; Director, Movement Disorders Center, The Neurological Institute, University Hospitals Case Medical Center, Cleveland, OH.
Learning Objectives
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| EDUCATIONAL GAP AND NEEDS ANALYSIS STATEMENT: There is a great need to maintain and improve the clinical diagnostic skills and knowledge of the Primary Care Practitioner in the field of Neurology. In view of the fact that as America ages, disorders such as CVAs, Dementia, and Parkinson’s, etc. will increasingly be seen by the Primary Care Practitioner. This CME activity addresses these issues and satisfies the need to improve the abilities of practitioners to diagnose neurological conditions through greater reliance on clinical skills and knowledge and less reliance on specialty referral. Discussing practical approaches to therapy of these common Neurological topics will help to improve physician competence and clinical outcomes.
| | Day 1 |
The Neurological Examination. Waking up to Sleep Disorders. Neurologic Emergencies, Parts I & II. |
| Day 2 |
An Approach to the Dizzy Patient. Peripheral Neuropathy and Neuropathic Pain Management. Seizures and Epilepsy – Diagnosis. Seizures and Epilepsy – Management. |
| Day 3 |
Migraine and Chronic Daily Headache. Syncope: Which Test is Better in the Fainting Patient? Drugs and the Nervous System. Multiple Sclerosis. |
| Day 4 |
Dementia. Parkinson’s Disease and Its Differential Diagnosis. Cobalamin (B-12) Deficiency and Other Neurologic Disorders of Gastrointestinal Function. Libby Zion’s Lesson: Serotonin Syndrome and Other P450 Drug Interactions. |
| Day 5 |
Stroke, Part I – Risk Factors and Prevention. Stroke, Part II – TIA and Acute Stroke. Spasticity, Ataxia, and Other Movement Disorders. Psychogenic Neurologic Disorders. |
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Neurology Updates for Primary Care
April 13-17, 2009
Location: Hyatt Regency Sarasota, Florida
OBJECTIVES
| OVERALL OBJECTIVES: The overall objective is to provide the participant with practical and clinically relevant information. Upon completion of this CME activity, the physician or healthcare provider should be able to describe the current approach to formulating differential diagnoses, diagnostic, therapeutic, and preventive management of the various disciplines presented. |
| SPECIFIC OBJECTIVES
| | Day 1 | The Neurological Examination. - Upon completion of this session, the participant should be able to:
| 1. | Organize the disparate parts of the neurologic examination into a personally relevant, manageable and reproducible diagnostic tool.
| | 2. | Identify clinical tests for specific neurologic functions.
| | 3. | Perform a screening neurologic exam for asymptomatic patients.
| | 4. | Perform a problem-tailored neurologic exam for patients with neurologic complaints.
| | Waking Up to Sleep Disorders. - Upon completion of this session, the participant should be able to:
| | 1. | Formulate a diagnostic and therapeutic approach to insomnia.
| | 2. | Describe the clinical features, associated disorders and treatment of sleep apnea.
| | 3. | Describe the clinical features and treatment of narcolepsy and REM-sleep behavior disorder.
| | 4. | Describe the clinical features, associated disorders and treatment of restless legs syndrome.
| | Neurologic Emergencies, Part I. - Upon completion of this session, the participant should be able to:
| | 1. | Recognize spinal cord compression, Guillain-Barré Syndrome, Myasthenic Crisis.
| | 2. | Demonstrate an approach to examination and diagnosis.
| | 3. | Discuss appropriate testing.
| | 4. | Apply principles to treatment and rehabilitation.
| | Neurologic Emergencies, Part II. - Upon completion of this session, the participant should be able to:
| | 1. | Recognize status epilepticus, coma, and subarachnoid hemorrhage
| | 2. | Identify pupillomotor function in CNIII Palsies and prognosis.
| | 3. | Discuss appropriate testing.
| | 4. | Apply principles to treatment and rehabilitation.
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| | Day 2 | An Approach to the Dizzy Patient. - Upon completion of this session, the participant should be able to:
| 1. | Define common presentations of dizziness.
| | 2. | Describe the pathophysiology of vertigo and nystagmus.
| | 3. | Apply bedside techniques to distinguish dizziness subtypes.
| | 4. | Demonstrate potentially curative treatment for benign positional vertigo.
| | Peripheral Neuropathy and Neuropathic Pain Management. - Upon completion of this session, the participant should be able to:
| | 1. | Define the spectrum of neuropathic signs, symptoms, and causes.
| | 2. | Develop an approach to bedside examination.
| | 3. | Discuss the mechanism of neuropathic pain.
| | 4. | Apply effective therapies.
| | Seizures and Epilepsy – Diagnosis. - Upon completion of this session, the participant should be able to:
| | 1. | Classify the major types of seizures.
| | 2. | Discuss the epidemiologic aspects of epilepsy.
| | 3. | Distinguish seizures from other transient neurologic events.
| | 4. | Formulate a plan for diagnostic investigation.
| | Seizures and Epilepsy – Management. - Upon completion of this session, the participant should be able to:
| | 1. | Differentiate among the many available anticonvulsant medications.
| | 2. | Determine when treatment with anticonvulsant medication is warranted.
| | 3. | Recognize and treat status epilepticus.
| | 4. | Evaluate and manage problems confronted by women with epilepsy.
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| | Day 3 | Migraine and Chronic Daily Headache. - Upon completion of this session, the participant should be able to:
| 1. | Review five sub-types of chronic daily headaches.
| | 2. | Describe the pathophysiology of headache and migraine.
| | 3. | Review medication and non-pharmacologic strategies.
| | 4. | Recognize the prevalence of medication overuse headaches in daily practice.
| | Syncope: Which Test is Better in the Fainting Patient? - Upon completion of this session, the participant should be able to:
| | 1. | Discuss the causes and natural history of syncope.
| | 2. | Apply bedside tilt and tilt table testing.
| | 3. | Define treatment strategies for orthostatic hypotension.
| | Drugs and the Nervous System. - Upon completion of this session, the participant should be able to:
| | 1. | Identify the common effects of prescribed drugs on the nervous system.
| | 2. | Identify the common effects of illicit drugs on the nervous system.
| | 3. | Recognize the common neurologic complications of alcoholism.
| | 4. | Recognize the common neurologic side effects of antidopaminergic medication.
| | Multiple Sclerosis. - Upon completion of this session, the participant should be able to:
| | 1. | Recognize the typical clinical features of multiple sclerosis.
| | 2. | Organize an appropriate series of diagnostic investigations.
| | 3. | Describe the approach to abortive and prophylactic therapy of multiple sclerosis.
| | 4. | Classify common treatable medical complications of multiple sclerosis.
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| | Day 4 | Dementia. - Upon completion of this session, the participant should be able to:
| 1. | Identify a patient with mild cognitive impairment or dementia.
| | 2. | Diagnose the major syndromes associated with common causes of dementia.
| | 3. | Develop a therapeutic plan for a patient with dementia.
| | 4. | Identify the conditions that frequently mimic dementia.
| | Parkinson’s Disease and Its Differential Diagnosis. - Upon completion of this session, the participant should be able to:
| | 1. | Identify the clinical features of the syndrome of parkinsonism.
| | 2. | Describe other important typical features of Parkinson’s disease and clinical features atypical for Parkinson’s disease.
| | 3. | Recognize long-term complications of Parkinson’s disease and major treatment options.
| | 4. | Distinguish among the common types of tremor and devise a therapeutic plan for a patient with essential tremor.
| | Cobalamin (B-12) Deficiency and Other Neurologic Disorders of Gastrointestinal Dysfunction. - Upon completion of this session, the participant should be able to:
| | 1. | Define recent advances in B-12 deficiency, Post-Gastroplasty Neuropathy, and Copper deficiency.
| | 2. | Examine the changing clinical presentation of this illness.
| | 3. | Apply newer laboratory techniques to the diagnosis.
| | 4. | Apply an algorithm for the diagnosis and treatment of B-12 deficiency.
| | Libby Zion’s Lesson: Serotonin Syndrome and Other P450 Drug Interactions. - Upon completion of this session, the participant should be able to:
| | 1. | Define the clinical features of common drug interaction.
| | 2. | List the features of serotonin syndrome and distinguish from other Neurologic drug toxicities.
| | 3. | Recognize potential drug interactions and determine how to predict them.
| | 4. | Apply a simple clinical algorithm for anticipating and avoiding drug interactions.
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| | Day 5 | Stroke, Part I - Risk Factors and Prevention. - Upon completion of this session, the participant should be able to:
| 1. | Recall risk factors and modification.
| | 2. | Apply principles of localization to classify stroke subtypes.
| | 3. | Recognize when to refer patients for carotid endarterectomy.
| | 4. | Determine use of aspirin, clopidogrel, dipyridamole, warfarin, heparin and carotid endarterectomy.
| | Stroke, Part II - TIA and Acute Stroke. - Upon completion of this session, the participant should be able to:
| | 1. | Define TIA.
| | 2. | Develop a protocol for evaluation and treatment of TIA and stroke.
| | 3. | Apply inclusion criteria and CT criteria for thrombolysis.
| | 4. | Evaluate outcomes, hemorrhage rate, recovery.
| | Spasticity, Ataxia and Other Movement Disorders. - Upon completion of this session, the participant should be able to:
| | 1. | Recognize the major clinical features of spasticity.
| | 2. | Plan a diagnostic investigation of cervical spondylosis.
| | 3. | Recognize ataxia and the other major clinical features of cerebellar dysfunction.
| | 4. | Distinguish among different types of involuntary movements.
| | Psychogenic Neurologic Disorders. - Upon completion of this session, the participant should be able to:
| | 1. | Describe the most common neurologic manifestations of psychogenic disorders.
| | 2. | Distinguish among malingering, factitious disorders and conversion disorders.
| | 3. | Identify the major risk factors for psychogenic illness.
| | 4. | Formulate a plan for management of a psychogenic illness.
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