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Internal Medicine CME

 
 
Internal Medicine Review & Update: Inpatient and Outpatient Care for the Hospitalist & PCP

November 23-27, 2009 (8:00am-12:15pm)
Location: Hyatt Regency Sarasota, Florida
20 AMA PRA Category 1 Credits™
20 CME Credits - ACEP AAFP ACOG
Course #SEMLA-2420091123
Price: $645.00 - $795.00

by David A. Horowitz, M.D. - University of Pennsylvania School of Medicine; Assistant Professor of Clinical Medicine; Senior Medical Director for Quality, University of Pennsylvania Health System; Chief Medical Officer, PennCare at Home, Home Care Division of UPHS, Philadelphia, PA and Kendal Williams, M.D., M.P.H. - University of Pennsylvania School of Medicine; Assistant Clinical Professor, Hospitalist Division; Service Chief, Penn Presbyterian Medical Center; Director, Center for Evidence-Based Practice, UPHS, Philadelphia, PA.

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 Practical Approach to Thyroid Disease: 1. Hypothyroidism/Elevated TSH 2. Patient with a Thyroid Nodule. Practical Approach to the Patient with Potential DVT. The Inpatient Management of Diabetes. The Evaluation and Management of Syncope.
Day 2 Overview of the Current Management of Health Care Associated Infections. Overview of the Inpatient Management of Skin and Soft Tissue Infections. Practical Approach to the Patient with Hypertension. Practical Approach to the Patient with Headache.
Day 3 Practical Approach to the Outpatient with Dementia. Practical Primer: A Measured Approach to Patient Safety and Error Theory. Delirium, Dementia, and Psychosis – The Diagnosis and Management of the Inpatient with Mental Status Change. Update on the Management of COPD and Asthma in the Hospitalized Patient.
Day 4 Update on the Evaluation of Chest Pain. Update on the Management of Acute Coronary Syndromes. Surgical, Medical, and Behavioral Approaches to the Patient with Obesity, Parts I & II.
Day 5 Practical Approach to the Patient with Diabetes. Practical Approach to the Patient with Hyperlipidemia. Update on the Management of Stroke. Update on the Management of Congestive Heart Failure.

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Internal Medicine Review & Update: Inpatient and Outpatient Care for the Hospitalist & PCP
November 23-27, 2009
Location: Hyatt Regency Sarasota, Florida

SPECIFIC OBJECTIVES
Day 1Practical Approach to Thyroid Disease: 1. Hypothyroidism/Elevated TSH 2. Patient with a Thyroid Nodule - Upon completion of this session, by applying recommendations from the AAFP, AACE, ACP, ATA, USPSTF, IOM, and ACOG, the participant should be able to:
1.Appreciate the role of the screening TSH and what to do with the results.
2.Develop a reasonable and cost-effective approach to diagnosing the thyroid nodule.
3.Discuss the management of hypothyroidism.
Practical Approach to the Patient with Potential DVT - Upon completion of this session, using multiple research trials as well as applying recommendations from the ACCP, AAFP/ACP, and the AHA/ACC, the participant should be able to:
1.Obtain an appropriate medial history to better identify those patients at risk.
2.More confidently evaluate and assess the patient suspected of having DVT.
3.Better manage patients with the confirmed diagnosis of DVT to include prophylaxis.
The Inpatient Management of Diabetes - Upon completion of this session, the participant should be able to:
1.Describe the basic principles of the inpatient management of diabetes, based on the guidance of the ADA and the American Society of Clinical Endocrinologists.
2.Review the use of basal insulin and short acting insulin analogues in the hospital.
3.Review the conflicting evidence for the importance of improved management of inpatient diabetes.
4.Discuss the transitional strategies for new or poorly controlled diabetics from inpatient to outpatient care.
The Evaluation and Management of Syncope. - Upon completion of this session, the participant should be able to:
1.Present a strategy to differentiate the causes of a syncopal event.
2.Review an evidence-based algorithm to evaluate recurrent syncopal episodes.
3.Review the diagnostic tests available for the evaluation of recurrent syncopal episodes and their appropriate use.
4.Review the therapeutic options for recurrent syncope based on recent systematic reviews of effective strategies.

Day 2Overview of the Current Management of Health Care Associated Infections - Upon completion of this session, the participant should be able to:
1.Based on evidence and publications from the CDC, review the recent trends in the epidemiology and anti-microbial resistance patterns of common hospital acquired infections.
2.Categorize the various types of hospital acquired infections and their common presentations.
3.Based on SHEA and HICPAC guidelines and current practice standards, describe the appropriate management of hospital acquired infections.
4.Discuss evidence-based strategies to prevent hospital acquired infections.
Overview of the Inpatient Management of Skin and Soft Tissue Infections - Upon completion of this session, the participant should be able to:
1.Review the clinical presentation and categorization of common skin and soft tissue infections and their common mimics.
2.Based on evidence from the CDC and standard of care publications, review the changing epidemiology and resistance patterns impacting skin and soft tissue infections.
3.Provide a rational management strategy for skin and soft tissue infections.
4.Based on standard of care publications and systematic reviews of evidence-based strategies, describe the management of skin and soft tissue infections in the diabetic patient.
Practical Approach to the Patient with Hypertension - Upon completion of this session, using multiple research trials as well as recommendations of the JNC VII, the participant should be able to:
1.Review the JNC VII recommendations for treatment of hypertension.
2.Consider a rational approach to choosing medication in treating hypertension.
3.Decide when and how to evaluate for secondary causes of hypertension.
Practical Approach to the Patient with Headache - Upon completion of this session, while applying recommendations from the IHC, NHF, AAFP, AAN, ACP, the participant should be able to:
1.Review the differential diagnosis of a patient presenting with the complaint of headache.
2.More confidently evaluate the patient with headache and appreciate the indications for imaging.
3.Develop a treatment plan that considers lifestyle changes as well as medications.

Day 3Practical Approach to the Outpatient with Dementia - Upon completion of this session, while applying recommendations from the AAN and the USPSTF, the participant should be able to:
1.Review a practical approach to screening for dementia.
2.Discuss medication management to include Polypharmacy, drug-drug interactions, as well as new drugs and their potential efficacy and side effects.
3.Develop a long-term follow-up and referral process that considers cost effective and resource management.
Practical Primer: A Measured Approach to Patient Safety and Error Theory - Upon completion of this session, using multiple research trials as well as the recommendations of the IOM, the participant should be able to:
1.Discuss a “primer” on medical error theory.
2.Develop a systems approach to learning and practice.
3.Apply the general principles of safety to reduce errors and improve outcomes.
Delirium, Dementia, and Psychosis – The Diagnosis and Management of the Inpatient with Mental Status Change - Upon completion of this session, the participant should be able to:
1.Review the diagnostic approach to the hospitalized patient with acute mental status change.
2.Discuss the differential diagnosis of psychosis in the hospitalized patient.
3.Based on a systematic review of the best evidence, review the evidence-based management of delirium in the hospital setting.
4.Review the diagnosis and evidence-based treatment of alcohol withdrawal syndromes.
Update on the Management of COPD and Asthma in the Hospitalized Patient - Upon completion of this session, the participant should be able to:
1.Review the initial management and stabilization of asthmatic and COPD patients.
2.Review the GOLD criteria for the management of COPD.
3.Review the acute and chronic management of asthma taking into account recent studies on the safety and effectiveness of various agents.

Day 4Update on the Evaluation of Chest Pain - Upon completion of this session, the participant should be able to:
1.Based on recent standard of care publications, review the contribution of history, physical exam, and EKG findings to the evaluation of chest pain based.
2.Distinguish ischemic EKG changes from their common mimics.
3.Highlight clinical scenarios and review the evidence for use of cardiac biomarkers in the diagnosis of ACS.
4.Review the diagnostic strategies for the evaluation of chest pain patients presenting to the emergency room.
Update on the Management of Acute Coronary Syndromes - Upon completion of this session, the participant should be able to:
1.Distinguish the forms of ACS and their relative prognoses.
2.Based on the most recent AHA/ACC guidelines, review the appropriate initial management of patients experiencing acute coronary syndromes.
3.Based on the most recent AHA/ACC guidelines, categorize the therapeutic options for patients with unstable angina and post- MI.
4.Based on the most recent AHA/ACC guidelines, review the secondary prevention strategies for patients who have experienced an acute coronary syndrome.
Surgical, Medical, and Behavioral Approaches to the Patient with Obesity, Parts I & II - Upon completion of this session, using multiple research trials as well as applying recommendations from the AGA, NIH – NHLBI, ACP, AHA, ASBS, and ACS, the participant should be able to:
1.Consider the indications for bariatric surgery in addition to the nonsurgical approaches to weight loss.
2.Recognize the outcomes, advantages and disadvantages of bariatric surgery.
3.Review the current popular diets available and marketed to your patients.
4.Take in to consideration unique needs of the obese patient in order create a comprehensive approach to the treatment of obesity.
5.Explain the basic physiology of obesity.
6.Manage the medications available for the treatment of obesity.
Day 5Practical Approach to the Patient with Diabetes - Upon completion of this session, using multiple research trials as well as recommendations from the ADA, EASN, AGA, CDA, AACE, ACP, and the AAFP, the participant should be able to:
1.Consider this primer on management.
2.Identify the patient who is likely to go on to develop complications and appreciate the potential long term course.
3.Review the current guidelines for therapy and the anticipated outcome goals.
Practical Approach to the Patient with Hyperlipidemia - Upon completion of this session, using multiple research trials as well as the recommendations of the NCEP (ATP III), the participant should be able to:
1.Discuss the current NCEP guidelines.
2.Develop a practical approach for considering the new medications available.
3.Consider the new targets developed for cholesterol end points.
Update on the Management of Stroke - Upon completion of this session, the participant should be able to:
1.Review common presentations of cerebrovascular insufficiency.
2.Update the initial management of patients with a suspected acute CVA.
3.Describe cutting edge strategies and therapies for the management of hemorrhagic and thrombotic strokes.
4.Characterize the prognosis and initial rehabilitation strategies of CVA patients.
Update on the Management of Congestive Heart Failure - Upon completion of this session, the participant should be able to:
1.Distinguish the forms and differing presentations of cardiomyopathy subtypes.
2.Based on the AHA guidelines, review the initial management of patients with acute congestive heart failure.
3.Based on the AHA guidelines, review the strategies for the effective chronic management of CHF that impact the care of hospitalized patients.
4.Discuss diastolic heart failure and pulmonary hypertension.

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