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Live CME Seminars
Primary Care CME |
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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 and Inaugural Jaharis Family Chair (2001-2009), Department of Family Medicine; Boston, MA; Herbert L. Muncie, Jr., M.D. - Louisiana State University Health Sciences Center School of Medicine; Professor of Family Medicine and Director, Medical Student
Education, Department of Family Medicine; New Orleans, LA and Gary H. Oberlender, M.D., F.A.C.P. - Consultant in Geriatric Medicine.
Learning Objectives
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NARRATIVE DESCRIPTION: Following this course, the participant should be able to appraise the etiologies and recognize the clinical presentations of the commonly seen disorders presented; indicate diagnostic tests available and the suggested use for making a diagnosis; implement available treatment options and appropriate long-term care when indicated. This activity is expected to result in improved competence in making an appropriate diagnosis and providing effective treatment and referral or follow-up care with the overall goal of improving patient outcomes.
When indicated in the specific objectives, emphasis will be on aligning physician behavior with current guidelines and evidence-based medicine with a focus on diagnosis, treatment and when to refer. This course was designed to inter-relate the disorders presented in an effort to help all practitioners at the level of a practicing physician or practitioner relate their practice strategies with other providers and specialists. By doing this, it will provide them with increased competence to appropriately diagnose and refer or effectively treat their patients’ conditions to optimize their care.
| | Day 1 |
Sensible Prescribing Practices for the Elderly. Venous Thromboembolism (VTE): Diagnosis and Treatment. Advanced Nutritional Assessment and Therapy. Use and Interpretation of Thyroid Tests. |
| Day 2 |
Delirium in the Elderly – Current Concepts. Evaluation and Treatment of Hypertensive Patients. Evaluation and Treatment of Dementia in Seniors. Anemia – A Finding, Not Yet a Diagnosis. |
| Day 3 |
Migraine Headaches – Update on Diagnosis and Treatment. Vitamin B-12 Deficiency in the Elderly. Treating Patients with Type 2 Diabetes Mellitus. Contemporary Issues in End of Life Care. |
| Day 4 |
Adult Health Screening and Immunizations – Evidence-Based Approach. Osteoporosis. Chronic Obstructive Pulmonary Disease (COPD): Evaluation and Treatment. Musculoskeletal Disease in the Elderly. |
| Day 5 |
Evaluation and Initial Management: Benign Breast Disease. Urinary Incontinence. Hormonal Contraceptives: Good, Bad and Controversial. Atrial Fibrillation. |
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Primary Care: Improving Your Outcomes Through Diagnosis and Treatment
December 13-17, 2010
Location: Hyatt Regency Sarasota, Florida
| SPECIFIC OBJECTIVES
| | Day 1 | Sensible Prescribing Practices for the Elderly - Upon completion of this session, the participant should be able to:
| 1. | Appraise and appreciate the limits of studies on drug safety and efficacy as they apply to the elderly.
| | 2. | Assess the subtle but significant drug side effects in the elderly.
| | 3. | Distinguish undesirable prescribing practices and employ better approaches.
| | Venous Thromboembolism (VTE): Diagnosis and Treatment - Upon completion of this session, using the ACCP and ATS Guidelines and the Cochrane Abstract Database, the participant should be able to:
| | 1. | Determine the appropriate diagnostic testing for evaluating a patient for VTE based upon the sensitivity and specificity of the diagnostic tests.
| | 2. | Employ the algorithm for diagnosing a PE in multiple clinical settings.
| | 3. | Differentiate the advantages of outpatient treatment compared to inpatient treatment for VTE.
| | 4. | Recommend the appropriate frequency of monitoring and the adjustments needed for warfarin therapy in the treatment of VTE.
| | Advanced Nutritional Assessment and Therapy - Upon completion of this session, the participant should be able to:
| | 1. | Utilize readily available clinical data to make accurate nutritional assessments in seniors.
| | 2. | Relate metabolic changes in aging to assess risk for malnutrition.
| | 3. | Develop a range of therapeutic nutritional approaches for frail and sick elderly patients.
| | 4. | Apply literature-based information on nutritional approaches that reduce the risk of dementia and depression to patients in his or her practice.
| | Use and Interpretation of Thyroid Tests - Upon completion of this session, using the American Thyroid Association Guidelines and the Cochrane Abstract Database, the participant should be able to:
| | 1. | Determine the appropriate serum tests for thyroid function for multiple clinical situations.
| | 2. | Interpret the various combinations of thyroid tests results that occur in clinical settings.
| | 3. | Recommend the appropriate follow-up testing of abnormal thyroid tests and frequency of these evaluations.
| | 4. | Analyze the impact of other medications on thyroid function testing and the evidence-based recommendations for managing the medications’ side effects.
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| | Day 2 | Delirium in the Elderly - Current Concepts - Upon completion of this session, the participant should be able to:
| 1. | Evaluate the diagnostic features and common causes of delirium.
| | 2. | Determine the causes of persistent delirium.
| | 3. | Formulate the non-pharmacologic and pharmacologic treatment approaches to the delirious patient.
| | 4. | Develop and prescribe various options to address agitation.
| | Evaluation and Treatment of Hypertensive Patients - Upon completion of this session, using the JNC VII Guidelines, the Cochrane Abstract Database and the evidence-based reports from Clinical Evidence, the participant should be able to:
| | 1. | Recommend the non-pharmacologic treatment options to manage hypertension.
| | 2. | Determine the appropriate pharmacologic treatment options for patients with compelling indications based upon JNC VII Guidelines.
| | 3. | Formulate the appropriate therapeutic goal for controlling blood pressure in different patient populations and the combination of medications that can achieve that goal.
| | Evaluation and Treatment of Dementia in Seniors - Upon completion of this session, the participant should be able to:
| | 1. | Determine the common causes of cognitive dysfunction and dementia in seniors.
| | 2. | Develop a unified comprehensive approach to the medical evaluation of a senior with cognitive dysfunction.
| | 3. | Distinguish and relate the relative risks and benefits of available treatment options.
| | 4. | Recognize the central role of caregiver education and caregiver support in the treatment of seniors with dementia.
| | Anemia – A Finding, Not Yet a Diagnosis - Upon completion of this session, using the Cochrane Abstract Database and AAFP Guidelines, the participant should be able to:
| | 1. | Determine the etiologies for common anemia.
| | 2. | Construct the diagnostic evaluation needed to determine the etiology of anemia.
| | 3. | Recommend the evidence-based therapeutic options for each identified anemia.
| | 4. | Formulate the appropriate follow-up evaluations for assessing the treatment efficacy for each anemia.
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| | Day 3 | Migraine Headaches – Update on Diagnosis and Treatment - Upon completion of this session, using the International Headache Society and U.S. Headache Consortium Guidelines and the National Guideline Clearinghouse and the evidence-based reports from Clinical Evidence, the participant should be able to:
| 1. | Develop the approach for evaluating a patient with possible migraine headaches based upon evidence-based guidelines.
| | 2. | Relate the advantages of supportive therapy and lifestyle changes in treating migraine headaches compared to pharmacologic therapy.
| | 3. | Recommend the pharmacologic options for treating the acute pain of a migraine headache based upon evidence-based guidelines.
| | 4. | Design a prophylactic therapy regimen for patients with recurrent migraine headaches.
| | Vitamin B-12 Deficiency in the Elderly - Upon completion of this session, the participant should be able to:
| | 1. | Describe the normal physiology of Vitamins B-12 and D.
| | 2. | Describe the variety of pathologic syndromes that may be due to the deficiencies of Vitamins B-12 and/or D.
| | 3. | Develop the work-up of Vitamin B-12 and Vitamin D deficiency and therapeutic options.
| | Treating Patients with Type 2 Diabetes Mellitus - Upon completion of this session, using the American Diabetes and the European Association for the Study of Diabetes Guidelines and Cochrane Abstract Database, the participant should be able to:
| | 1. | Evaluate the therapeutic goals in treating type 2 diabetes and their impact on morbidity and mortality.
| | 2. | Recommend the approach, based upon evidence-based guidelines, for choosing oral hypoglycemic agents to treat type 2 diabetes.
| | 3. | Select the clinical situations that would require the use of insulin to treat type 2 diabetes and the probable dosage form and average amounts required for control of A1c.
| | Contemporary Issues in End of Life Care - Upon completion of this session, the participant should be able to:
| | 1. | Develop a practical approach to assessment of the whole patient in a hospice setting.
| | 2. | Formulate effective approaches to common physical symptoms in the terminally ill.
| | 3. | Integrate effective clinical care of patients and their families in the last days of life.
| | 4. | Relate dementia as a terminal illness.
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| | Day 4 | Adult Health Screening and Immunizations – Evidence-Based Approach - Upon completion of this session, using the USPSTF and Cochrane Abstract Database, the participant should be able to:
| 1. | Apply the evidence-based recommendations for preventive screening tests for adults.
| | 2. | Determine the immunizations required for adults in various clinical encounters.
| | 3. | Determine the side effects of adult immunizations and their management.
| | 4. | Select the contraindications for each adult immunization and their alternative therapy.
| | 5. | Recommend when screening tests can be discontinued in adults.
| | 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.
| | Chronic Obstructive Pulmonary Disease (COPD): Evaluation and Treatment - Upon completion of this session, using the ACCP GOLD guidelines, the AACVPR practice guidelines and the evidence-based reports from Clinical Evidence, the participant should be able to:
| | 1. | List the diagnostic criteria for COPD.
| | 2. | Describe the natural history of COPD and the influence of smoking cessation.
| | 3. | Compare and contrast the pharmacologic treatment options to reduce morbidity associated with COPD.
| | 4. | Describe the usual follow-up assessments of patients diagnosed with COPD.
| | 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.
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| | Day 5 | Evaluation and Initial Management: Benign Breast Disease - Upon completion of this session, using the American Cancer Society Guidelines and the Cochrane Abstract Database, the participant should be able to:
| 1. | Differentiate the signs and symptoms associated with benign breast disease from breast cancer.
| | 2. | Formulate an evidence-based evaluation for breast pain, breast lumps, and nipple discharge.
| | 3. | Recommend the evidence-based treatment options for breast pain, nipple discharge and breast infections.
| | 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.
| | Hormonal Contraceptives: Good, Bad and Controversial - Upon completion of this session, using the ACOG Practice Guidelines and the Cochrane Abstract Database, the participant should be able to:
| | 1. | Appraise the pharmacologic differences in oral contraceptives and their role in contraceptive efficacy.
| | 2. | Differentiate the relative and absolute contraindications to oral contraceptives.
| | 3. | Determine the circumstances that would be eligible for emergency contraception and the most appropriate method of emergency contraception for each situation.
| | 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.
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