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Geriatrics CME

 
 
Geriatrics: A Primary Care Approach to the Aging Population

January 31 - February 4, 2011 (8:00am-12:15pm)
Location: Hyatt Regency Sarasota, Florida
20 AMA PRA Category 1 Credits™
20 CME Credits - AAFP ACEP ACOG
Course #SEMLA-2520110131
Price: $645.00 - $795.00

by Gary H. Oberlender, M.D., F.A.C.P. - Consultant in Geriatric Medicine and John W. Pendleton, M.D., F.A.C.P, F.A.C.R. - Virginia Tech Carilion School of Medicine and Research Institute; Associate Professor of Internal Medicine; Assistant Professor of Clinical Medicine, University of Virginia School of Medicine; Chief, Rheumatology Section, Veterans Affairs Medical Center; Staff Rheumatologist, Carilion Clinic, Carilion Roanoke Memorial Hospital, Roanoke, VA.

Learning Objectives
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NARRATIVE DESCRIPTION: Following this course, the participant should be able to identify the etiologies, epidemiologies and presenting clinical manifestations of the disorders described; implement a differential diagnosis and laboratory assessment plans; outline the therapeutic intervention, possible complications and preventive measures. 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.

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. In consideration of our aging population, a physician is expected to be competent in the fundamentals of Geriatric Medicine and rely upon specialist only when absolutely necessary; therefore, this course was designed as a review and update for all practitioners at the level of a practicing physician.

Day 1 Delirium in the Elderly – Current Concepts. Osteoporosis: Contemporary Diagnosis and Treatment. Dementia in the Elderly. Osteoarthritis: Diagnosis and Treatment in the Older Patient.
Day 2 Advanced Nutritional Assessment and Therapy. Practical Points for the Musculoskeletal Exam for the Primary Care Provider. Vitamin B-12 and Vitamin D in Seniors. Geriatric Depression: Advances in Diagnosis and Treatment.
Day 3 Exercise Program in the Elderly “A Movement Whose Time Has Come”. Sensible Approaches to Geriatric Infections. Rheumatologic Lab Tests and Rheumatoid Arthritis in the Elderly. A Practical Approach to Falls and Urinary Incontinence.
Day 4 Sensible Prescribing Practices for the Elderly. Treatment of Chronic Pain in the Elderly. Contemporary Issues in End of Life Care. Office Orthopedics in the Older Patient.
Day 5 Polymyalgia Rheumatica and Giant Cell Arteritis. Risk Management and Care of the Elderly. Gout and Pseudogout in the Elderly. Improving Communication Skills in Medical Practice.

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Geriatrics: A Primary Care Approach to the Aging Population
January 31 - February 4, 2011
Location: Hyatt Regency Sarasota, Florida

SPECIFIC OBJECTIVES
Day 1Delirium 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.
Osteoporosis: Contemporary Diagnosis and Treatment - Upon completion of this session, the participant should be able to:
1.Assess the differences in the WHO, physiologic, and clinical definition of osteoporosis.
2.Distinguish between the effects on bone metabolism of aging and those during the post-menopausal period.
3.Recognize the limitations of using only the T-score in assessing the risk of fracture.
4.Specify the importance of adequate vitamin D and calcium in the treatment of Osteoporosis.
Dementia in the Elderly - 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.
Osteoarthritis: Diagnosis and Treatment in the Older Patient - Upon completion of this session, the participant should be able to:
1.Appraise the newer understandings of the pathophysiology of OA.
2.Distinguish the typical and atypical clinical features of OA.
3.Relate the various treatments of OA and how to integrate them.
4.Distinguish OA symptoms from those of other localized or generalized disorders.

Day 2Advanced 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.
Practical Points for the Musculoskeletal Exam for the Primary Care Provider - Upon completion of this session, the participant should be able to:
1.Apply the various maneuvers in the shoulder exam to detect an impingement syndrome and adhesive capsulitis.
2.Assess the various causes of swelling and pain in the elbow and apply the maneuvers to distinguish them.
3.Relate the location of pain and the earliest exam changes noted in arthritis of the hip.
4.Employ the most sensitive test to detect effusions of the knee joint.
Vitamin B-12 and Vitamin D in Seniors - 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.
Geriatric Depression: Advances in Diagnosis and Treatment - Upon completion of this session, the participant should be able to:
1.Differentiate the variety of clinical presentations of depressive syndromes in the elderly.
2.Appraise the utility of, and plan to use, the Geriatric Depression Scale.
3.Integrate the relative advantages and disadvantages of the various medications available for treatment of depression.
4.Appraise and appreciate the role of nutritional supplementation and non-pharmacologic treatments in conjunction with medical treatments.

Day 3Exercise Program in the Elderly “A Movement Whose Time Has Come” - Upon completion of this session, the participant should be able to:
1.Integrate the relationship between maximal oxygen consumption, aging, and functional status.
2.Relate the potential benefits of exercise.
3.Assess the risks of exercise and how to minimize them.
4.Specify the components of an exercise program.
Sensible Approaches to Geriatric Infections - Upon completion of this session, the participant should be able to:
1.Detect atypical presentations of infectious illness in the elderly.
2.Differentiate the causes of pneumonia and UTI and order appropriate antibiotics.
3.Appraise current considerations in emerging antibiotic resistance.
4.Formulate options in the prevention and treatment of antibiotic associated diarrhea.
Rheumatologic Lab Tests and Rheumatoid Arthritis in the Elderly - Upon completion of this session, the participant should be able to:
1.Determine the impact of aging on the sensitivity and specificity of rheumatologic lab tests.
2.Differentiate the alterations in the presentation of rheumatoid arthritis in the elderly.
3.Appropriately apply the use of corticosteroids in elderly onset rheumatoid arthritis.
4.Detect clinical factors that predict progressive and destructive rheumatoid arthritis.
5.Analyze the ADRs of biologic treatments in RA.
A Practical Approach to Falls and Urinary Incontinence - Upon completion of this session, the participant should be able to:
1.Integrate the concept of multifactorial causes underlying falls and incontinence in seniors.
2.Develop a full assessment approach to evaluate different causes, using detailed physical examination and functional performance evaluations.
3.Differentiate the effects of normal aging from pathologic processes and adverse drug effects as contributing to the causes of falls and incontinence.
4.Apply a literature-based approach to the formulation of a treatment plan.

Day 4Sensible 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.
Treatment of Chronic Pain in the Elderly - Upon completion of this session, the participant should be able to:
1.Relate the adverse effects of NSAIDs in the elderly.
2.Prescribe long acting opiates after determining the daily dose requirements of short acting opiates.
3.Develop a treatment plan for an elderly patient with Fibromyalgia.
4.Specify the ADRs associated with opiate use in the elderly.
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.
Office Orthopedics in the Older Patient - Upon completion of this session, the participant should be able to:
1.Evaluate the common causes of acute low back pain in the elderly.
2.Appraise the symptoms of and prescribe treatment for spinal stenosis.
3.Differentiate between the different metabolic pathways of the statins and relate how that would impact prescribing for patients on multiple other drugs.
4.Recommend the best radiographic view of the shoulder to detect a posterior dislocation.

Day 5Polymyalgia Rheumatica and Giant Cell Arteritis - Upon completion of this session, the participant should be able to:
1.Integrate and relate the typical symptoms, physical findings, and laboratory abnormalities in polymyalgia rheumatica.
2.Determine the best prednisone doses as initial treatment of PMR.
3.Detect the typical and atypical presentations of GCA.
4.Determine the appropriate indication and technique for temporal artery biopsy.
5.Prescribe the most effective treatment and distinguish the most serious complications of GCA.
Risk Management and Care of the Elderly - Upon completion of this session, the participant should be able to:
1.Relate basic principles of effective risk management practices.
2.Apply newer concepts and approaches in dealing with medical errors.
3.Specify the benefits of honest disclosure of medical errors.
Gout and Pseudogout in the Elderly - Upon completion of this session, the participant should be able to:
1.Distinguish the unique characteristics of gout in the elderly.
2.Differentiate the factors in the elderly that impact the presentation and treatment of gout.
3.Determine the clinical manifestations of calcium pyrophosphate deposition.
4.Differentiate the polarized microscopic findings for uric acid and CPPD crystals.
Improving Communication Skills in Medical Practice - Upon completion of this session, the participant should be able to:
1.Appraise the variety of ways that people perceive communication and process information.
2.Assess your personal communication strengths and limitations.
3.Determine communication issues unique to older patients.
4.Develop practices and apply skills to maximize effective communication and listening.

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