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Internal Medicine CME

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

November 22-26, 2010 (8:00am-12:15pm)
Location: Hyatt Regency Sarasota, Florida
20 AMA PRA Category 1 Credits™
20 CME Credits - AAFP ACEP ACOG
Mainpro-M1 (Canadian Physicians)
Course #SEMLA-2520101122
Price: $645.00 - $795.00



by David A. Horowitz, M.D. - University of Pennsylvania School of Medicine; Assistant Professor of Clinical Medicine; Associate Chief Medical Officer, Penn Medicine; Chief Medical Officer, PennCare at Home, Home Care Division, 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; Co-Director, Center for Evidence-Based Practice, Penn Medicine, 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 improved competence in making 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 aligning physician behavior with 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 application of medical knowledge and practice strategies to diagnose, treat and improve patient care.

Day 1 Practical Approach to the Patient with Potential DVT. Practical Approach to Thyroid Disease: 1. Hypothyroidism/Elevated TSH 2. Patient with a Thyroid Nodule. The Inpatient Management of Diabetes. The Evaluation and Management of Syncope.
Day 2 Overview of the Current Management of Hospital Acquired Infections. Overview of the Inpatient Management of Skin and Soft Tissue Infections. Practical Approach to the Patient with Diabetes. Practical Approach to the Patient with Headache.
Day 3 Practical Approach to the Outpatient with Dementia. Practical Primer: A Measured Approach to the 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. Non-Surgical Approaches to the Patient with Obesity. Surgical Approaches to the Patient with Obesity.
Day 5 Practical Approach to the Patient with Hypertension. Practical Approach to the Patient with Hyperlipidemia. Update on the Management of Stroke. Update on the Management of Congestive Heart Failure in the Hospitalized Patient.

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Internal Medicine Review & Update: Inpatient and Outpatient Care for the Hospitalist & PCP
November 22-26, 2010
Location: Hyatt Regency Sarasota, Florida

SPECIFIC OBJECTIVES
Day 1Practical 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 medical 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.
Practical 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.
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 (ADA/ASCE Position Statement).
2.Apply the ADA and ASCE principles of inpatient diabetes management by demonstrating them in common clinical scenarios.
3.Discuss the chronic care management of diabetes.
4.Illustrate strategies to integrate the inpatient care with the chronic care of the diabetic patient.
5.Identify challenging diabetes management scenarios in the inpatient setting and distinguish between potential management strategies.
The Evaluation and Management of Syncope - Upon completion of this session, the participant should be able to:
1.Illustrate a strategy to differentiate the causes of a syncopal event.
2.Debate the value of the various diagnostic approaches for the workup of syncope.
3.Describe the therapeutic options for recurrent syncope based on recent systematic reviews of effective strategies.
4.Demonstrate the principles of syncope evaluation and management in common clinical scenarios.

Day 2Overview of the Current Management of Hospital Acquired 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, illustrate the appropriate management of various hospital acquired infections.
4.Relate evidence-based strategies to prevent and manage hospital acquired infections to the inpatient environment.
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.
2.Differentiate common non-infectious conditions that can mimic skin and soft tissue infections.
3.Based on evidence from the CDC and standard of care publications, review the changing epidemiology and resistance patterns impacting skin and soft tissue infections.
4.Discuss and differentiate between common skin and soft tissue infections and less common infections seen in only specific conditions.
5.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 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.Distinguish the patient who is likely to go on to develop complications and appreciate the potential long-term course.
3.Apply the current guidelines for therapy and access the anticipated outcome goals.
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.Formulate 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.Differentiate between delirium, dementia, and psychosis in the hospitalized patient.
3.Based on a systematic review of the best evidence, demonstrate the management of delirium in the hospital setting.
4.Review the diagnosis and treatment of alcohol withdrawal syndromes and demonstrate an evidence-based approach to its prevention and management.
Update on the Management of COPD and Asthma in the Hospitalized Patient - Upon completion of this session, the participant should be able to:
1.Differentiate between the initial management and stabilization of asthmatic and COPD patients.
2.Illustrate the evidence-based Global Obstructive Lung Disease (GOLD) criteria for the chronic management of COPD.
4.Demonstrate 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.
2.Distinguish ischemic EKG changes from their common mimics.
3.Review the evidence for use of cardiac biomarkers and cardiac CT scans in the diagnosis of ACS.
4.Apply the diagnostic strategies for the evaluation of chest pain to 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, illustrate 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, demonstrate appropriate secondary prevention strategies for patients who have experienced an acute coronary syndrome.
Non-Surgical and Surgical Approaches to the Patient with Obesity - 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.Determine the indications for bariatric surgery in addition to the nonsurgical approaches to weight loss.
2.Assess the outcomes, and evaluate the 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 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.Apply the JNC VII recommendations for treatment of hypertension.
2.Develop 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 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.Apply 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.Illustrate the initial management of patients with a suspected acute CVA.
3.Develop cutting edge strategies and therapies for the management of hemorrhagic and thrombotic strokes.
4.Based on the new evidence from advanced imaging technology, distinguish between stroke and TIA and illustrate the new guidance for the management of TIA episodes.
Update on the Management of Congestive Heart Failure in the Hospitalized Patient - Upon completion of this session, the participant should be able to:
1.Distinguish the forms and differing presentations of congestive heart failure subtypes.
2.Based on the AHA guidelines, review the initial management of patients with acute left sided congestive heart failure.
3.Based on the AHA guidelines, illustrate the strategies for the effective chronic management of left sided CHF that impact the care of hospitalized patients.
4.Discuss diastolic heart failure and illustrate effective management strategies.
5.Differentiate the various forms of pulmonary hypertension and illustrate the differences in their management.

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