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by Robert L. Dickman, M.D., F.A.A.F.P., A.G.S.F. - Tufts University School of Medicine; Associate Clinical Professor, Department of Public Health and Family Medicine and Jaharis Family Chair of Family Medicine, Boston, MA; by Kevin S. Ferentz, M.D. - University of Maryland School of Medicine; Associate Professor and Director of Clinical Operations, Department of Family Medicine, Baltimore, MD and by Lisa R. Ferentz, L.C.S.W.-C., DAPA - University of Maryland School of Social Work; Clinical Instructor and Faculty Member, Department of Family and Community Medicine; Founder and President, The Institute for Advanced Psychotherapy Training and Education, Inc.; Clinical Social Worker, Private Practice and Clinical Social Work Consultant, Baltimore, MD.
Learning Objectives
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| EDUCATIONAL GAP AND NEEDS ANALYSIS STATEMENT: Family Medicine Practitioners are expected to promote preventive care and a healthy population. This is an immediate challenge for Family Medicine and all Primary Care Practitioners. Needs analysis specifically identifies the ability to diagnose, treat and appropriately refer patients who present with significant national healthcare issues such as obesity, asthma, the need to stop smoking, depression and CAD. As America ages, the geriatric population will increasingly challenge our Primary Care Practitioners and clinics. Therefore, needs analysis on topics such as dementia, delirium, rational drug therapy, falls, musculoskeletal disease in the Elderly and Ethical Decision Making at the End of Life reveals knowledge gaps as well. Educational gap analysis has identified two areas that must be addressed: increased knowledge and increased confidence on the part of Primary Care Practitioners in these areas of Medicine. To address these needs and close these gaps, this activity presents current thinking and new information that will help Primary Care Providers maintain and update their knowledge and provide them with the confidence to diagnose, treat and refer their patients with the expectation of improving patient outcomes.
| | Day 1 |
Routine Adult Care. Rational Drug Therapy in the Elderly. Improving Compliance. Geriatric Depresion: Advances in Diagnosis and Treatment. |
| Day 2 |
Asthma. Atrial Fibrillation. Coronary Artery Disease. Falls in the Elderly. |
| Day 3 |
Food for Thought: Understanding and Working with Eating Disorders. Musculoskeletal Disease in the Elderly. Anemia. Osteoporosis. |
| Day 4 |
Identification and Treatment of Traumatized Patients. Delirium in the Elderly. Depression and Anxiety in Primary Care. Dementia in the Elderly. |
| Day 5 |
Smoking Cessation. Ethical Decision Making at the End of Life. Obesity. Urinary Incontinence. |
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Family Medicine: A Review and Update of Common Clinical Problems
June 8-12, 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 | Routine Adult Care. - Upon completion of this session, the participant should be able to:
| 1. | Identify the current primary care guidelines for recommended screening tests for adults.
| | 2. | List the various recommended immunizations for adults.
| | Rational Drug Therapy in the Elderly. - Upon completion of this session, the participant should be able to:
| | 1. | Describe the differences in pharmacokinetics and dynamics seen in the elderly.
| | 2. | Identify the strategies for safe prescribing in the elderly.
| | 3. | List at least 5 medications found on the Beer's List of Unsafe Drugs in the Elderly - this is a "fresh list".
| | Improving Compliance. - Upon completion of this session, the participant should be able to:
| | 1. | Identify the patient/physician communication issues that enhance compliance.
| | 2. | Enumerate techniques that they may use in their own practice to increase compliance.
| | 3. | Compare and contrast the follow-up plan for each STI.
| | Geriatric Depression: Advances in Diagnosis and Treatment. - Upon completion of this session, the participant should be able to:
| | 1. | Recognize atypical presentations for depression in the elderly.
| | 2. | Discuss the utility of various diagnostic tools including the Geriatric Depression Scale (GDS).
| | 3. | Appreciate unique aspects of treatment for Geriatric Depression.
| | 4. | Recognize pseudo-dementia as a presentation of Geriatric Depression.
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| | Day 2 | Asthma. - Upon completion of this session, the participant should be able to:
| 1. | Describe the epidemiology of asthma.
| | 2. | List the various modalities to diagnose asthma.
| | 3. | List the different treatments for asthma, both pharmacological and environmental.
| | Atrial Fibrillation. - Upon completion of this session, the participant should be able to:
| | 1. | Appreciate the incidence, prevalence and complications of AF in the elderly.
| | 2. | Describe the advantages and disadvantages of rate vs rhythm control in the elderly.
| | 3. | Determine the CHAD score and the indication for anti-coagulation in the elderly.
| | 4. | Recognize the potential benefit and harm of antiarrhythmic therapies.
| | Coronary Artery Disease. - Upon completion of this session, the participant should be able to:
| | 1. | Describe the common presenting symptom complexes of patients.
| | 2. | Describe the diagnostic evaluation of a patient with chest pain.
| | 3. | Enumerate current medication and surgical treatment options.
| | Falls in the Elderly. - Upon completion of this session, the participant should be able to:
| | 1. | List the common causes of falls.
| | 2. | Discuss easy to do office assessment of risk factors.
| | 3. | Describe fall prevention programs in the elderly.
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| | Day 3 | Food for Thought: Understanding and Working with Eating Disorders. - Upon completion of this session, the participant should be able to:
| 1. | Identify the behavioral and psychosocial triggers that promote eating disordered behaviors.
| | 2. | Define and explain anorexia, bulimia and binge eating behaviors.
| | 3. | Recognize the clinical “red flags” that indicate eating disordered behavior.
| | 4. | Identify and propose interventions designed to treat eating disordered behaviors.
| | Musculoskeletal Disease in the Elderly. - Upon completion of this session, the participant should be able to:
| | 1. | Describe the typical symptoms, physical findings and laboratory abnormalities in Polymyalgia Rheumatica (PMR).
| | 2. | Develop a differential diagnosis of monoarticular arthritis in the elderly.
| | 3. | Appreciate the typical and atypical presentations of Giant Cell Arteritis (GCA).
| | 4. | Recognize the difference in treatment for PMR and GCA.
| | Anemia. - Upon completion of this session, the participant should be able to:
| | 1. | List the guidelines for diagnosing anemia in children and adults.
| | 2. | List the common diagnostic studies available for diagnosing the etiology of the anemia.
| | 3. | Describe the role of consultants in the evaluation and management of anemia.
| | Osteoporosis. - Upon completion of this session, the participant should be able to:
| | 1. | Describe the pathological and clinical manifestations of Osteoporosis.
| | 2. | Appreciate the current approach to Osteoporosis screening in the elderly.
| | 3. | Describe the treatment of Osteoporosis including Ca, Vitamin D, Bisphosphonates and Calcitonin.
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| | Day 4 | Identification and Treatment of Traumatized Patients. - Upon completion of this session, the participant should be able to:
| 1. | Describe the characteristics associated with traumatic events.
| | 2. | Recognize and explain the “red flags” or symptomatic manifestations of trauma in patients.
| | 3. | Explain how to obtain a trauma history from a patient.
| | 4. | Identify and propose interventions designed to treat the symptoms of trauma.
| | Delirium in the Elderly. - Upon completion of this session, the participant should be able to:
| | 1. | List diagnostic features and common causes of delirium.
| | 2. | Distinguish between delirium and dementia.
| | 3. | Describe non-pharmacologic and pharmacologic treatment approaches to the delirious patient.
| | Depression and Anxiety in Primary Care. - Upon completion of this session, the participant should be able to:
| | 1. | Explain the incidence and prevalence of anxiety and depression.
| | 2. | Recognize the signs and symptoms associated with anxiety and depression.
| | 3. | Enumerate and describe treatment strategies available for these disorders.
| | Dementia in the Elderly. - Upon completion of this session, the participant should be able to:
| | 1. | Describe the prevalence and significance of dementia in the elderly population.
| | 2. | List common causes of dementia in the elderly.
| | 3. | List at least 3 treatable dementia syndromes.
| | 4. | Describe the risks and benefits of commonly used drugs to treat dementia.
| | 5. | Describe a reasonable medical evaluation of a newly identified patient.
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| | Day 5 | Smoking Cessation. - Upon completion of this session, the participant should be able to:
| 1. | Recognize the role of smoking in disease etiology.
| | 2. | Identify smoking cessation techniques which can be utilized in their practice setting.
| | Ethical Decision Making at the End of Life. - Upon completion of this session, the participant should be able to:
| | 1. | List the 3 ethical principles often used in end-of-life decision making.
| | 2. | Describe the differences between Power of Attorney, Living Wills and Guardianship.
| | 3. | Recognize the advantages and disadvantages of PEG feeding.
| | 4. | Appreciate the role of Hospice in end-stage dementia.
| | Obesity. - Upon completion of this session, the participant should be able to:
| | 1. | State the epidemiology of obesity in America and the health risks associated with obesity.
| | 2. | Assess patients that are obese and that are in need of treatment.
| | 3. | Recommend and utilize various treatment options available, including diet, exercise, medications, and bariatric surgery.
| | Urinary Incontinence. - Upon completion of this session, the participant should be able to:
| | 1. | Differentiate between Detrusor Instability, Stress and Overflow Incontinence.
| | 2. | Discuss the treatment of each type of Urinary Incontinence.
| | 3. | Appreciate the Standard of Care in the treatment of asymptomatic bacteruria in the elderly.
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