Family Medicine: Common Challenges in Internal Medicine and Geriatrics

Day 1

Hyperlipidemia and CV Disease Prevention – A Review of the Literature and Recent AHA Guidelines. (Malone)

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Create a diagnostic and treatment plan for patients based on the current evidence and AHA Guidelines.
2. Explain similarities and differences between the most recent and previous guidelines.
3. Identify areas of strength and weakness in the recent AHA Guidelines.
4. Utilize the most recent cholesterol guidelines at the point of care.

Carpal Tunnel Syndrome. (Malone)

Upon completion of this session, the participant should be able to: ^{EBM, COMP}

1. Apply an evidence-based approach to the identification of Carpal Tunnel Syndrome.
2. Detect clues that can help identify likely etiologies for Carpal Tunnel Syndrome.
3. Construct a differential diagnosis for Carpal Tunnel Syndrome.
4. Determine which patients would benefit from nerve conduction studies.
5. Discriminate the severity of Carpal Tunnel Syndrome.
6. Use EBM to select an appropriate treatment plan for Carpal Tunnel Syndrome.

Delirium in the Elderly – Current Concepts (Oberlender)

1. Upon completion of this session, the participant should be able to: EBM, COMP
2. Specify diagnostic features and common causes of delirium in seniors.
3. Distinguish the causes of persistent delirium.
4. Use evidence based medicine to formulate treatment approaches to delirious seniors.
5. Recognize treatment options for intermittent agitation using evidence based medicine.

Evaluation and Treatment of Dementia in Seniors (Oberlender) Upon completion of this session, the participant should be able to:                EBM, COMP

1. Determine the common causes of cognitive dysfunction and dementia in seniors.
2. Develop an evidence based evaluation of seniors with cognitive dysfunction.
3. Evaluate the relative risks and benefits of available treatment options for dementia in seniors.
4. Distinguish the central role of caregiver education and support in treating seniors with dementia.

Update Diabetes Mellitus Type II (Malone)

Attendees of this presentation should be able to:

1. Devise individualized therapeutic goals for   patients with Diabetes Mellitus Type II
2. Formulate a systematic approach for the use of oral hypoglycemic agents in patients with type 2 diabetes.
3. Specify the clinical situations in which insulin would be recommended to treat type 2 diabetes
4. Develop the therapeutic treatment plan for preventing diabetic complications

Day 2

Advanced Nutritional Assessment and Therapy. (Oberlender)

Upon completion of this session, the participant should be able to: EBM, COMP

1. Integrate readily available clinical data to make accurate nutritional assessments in seniors.
2. Relate metabolic changes in aging to assess risk for malnutrition
3. Apply an evidence based approach to treatment of undernutrition in seniors.

Vitamin B-12 and Vitamin D in Seniors (Oberlender)              

Upon completion of this session, the participant should be able to: EBM, COMP

1. Integrate the normal physiology of Vitamins B-12 and D.
2. Differentiate the pathologic syndromes associated with B-12 and D deficiency.
3. Develop an evidence based evaluation of B-12 and D deficiency for seniors.
4. Develop an evidence based approach to treatment options for B-12 and D in seniors.

Headaches Disorders (Malone)

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: ^{EBM, GL, COMP}

1. Construct the approach for evaluating a patient with possible migraine headaches.
2. Assess the advantages of supportive therapy and lifestyle changes in treating migraine headaches compared to pharmacologic therapy.
3. Appraise the pharmacologic options for treating the acute pain of a migraine headache.
4. Recommend a prophylactic therapy regimen for patients with recurrent migraine headaches.

Irritable Bowel Syndrome. (Malone)

Upon completion of this session, the participant should be able to: ^{EBM, COMP}

1. Appraise possible etiologies for Irritable Bowel Syndrome.
2. Select and utilize diagnostic criteria to identify IBS, based on the current medical evidence and expert recommendations.
3. Use the current medical literature to assess and screen for other conditions that can present with similar IBS symptoms.
4. Detect “red flag” signs and symptoms that should make one question the diagnosis of IBS.
5. Formulate an EBM diagnostic evaluation for patients with signs and symptoms of IBS.
6. Use the current medical literature to develop an EBM treatment plan for Irritable Bowel Syndrome.

Dyspepsia. (Malone)

Upon completion of this session, the participant should be able to: ^{EBM, COMP}

1. Appraise symptoms and common etiologies for dyspepsia.
2. Use EBM to detect “alarm symptoms” that are suspicious for GI malignancy.
3. Apply current medical evidence and expert guidelines to construct a diagnostic evaluation for Dyspepsia.
4. Determine appropriate treatment for Dyspepsia based on current medical evidence and the likely etiology.

Day 3

Approach to the Management of Stroke (Horowitz)

Upon completion of this session, the participant should be able utilize the latest evidence based medicine and guidelines to: ^{EBM, GL, COMP}

1. Develop a strategy to assess the common presentations of stroke/TIA.
2. Utilize current initial treatment strategies appropriately.
3. Develop a strategy to stratify the risk of stroke.
4. Develop a secondary prevention plan.

Practical Approach to the Diagnosis and Management of Heart Failure (Horowitz)

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Appraise the symptoms of congestive heart failure and detect the common causes of systolic heart failure.
2. Employ the current standard-of-care therapies.
3. Determine which patients will benefit from device therapy and specify when to refer patients for more advanced cardiac care.
4. Be familiar with, and be able to apply, the 2013 ACCF/AHA Guidelines for the Management of Heart Failure

Sensible Approaches to Geriatric Infections (Oberlender)

Upon completion of this session, the participant should be able to: EBM, COMP

1. Recognize atypical presentations of infectious illness in the elderly.
2. Differentiate the causes of pneumonia and UTI in seniors.
3. Specify an evidence based approach to appropriate antibiotic usage.
4. Appraise evidence based considerations in emerging antibiotic resistance.
5. Apply evidence based options in the prevention and treatment of C. difficile illness in seniors.

Geriatric Depression: Advances in Diagnosis and Treatment (Oberlender)

Upon completion of this session, the participant should be able to: EBM, COMP

1. Differentiate the variety of clinical presentations of depressive disorders in seniors.
2. Appraise the utility of, and plan to use, the Geriatric Depression Scale.
3. Apply an evidence based approach to antidepressant drug therapy in seniors.
4. Apply the evidence based recommendations for use of non-drug antidepressant therapy.

Sensible Prescribing Practices for the Elderly (Oberlender)         

Upon completion of this session, the participant should be able to: EBM, COMP

1. Appraise and appreciate the limits of published trials studies on drug safety and efficacy for seniors.
2. Assess the subtle but significant drug side effects in the elderly.
3. Distinguish undesirable prescribing practices and employ better approaches based on current evidence-based referenced literature.

Day 4

Practical Approach to the Patient with Hypertension. (Horowitz)

Upon completion of this session, using multiple research trials as well as the current JNC recommendations, the participant should be able to: ^{GL, COMP}

1. Apply the current JNC 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

Approach to the Management of Chest Pain (Horowitz)

Upon completion of this session, the participant should be able to: ^{GL, COMP}

1. Evaluate the complaint in the context of history, physical exam, and EKG findings.
2. Develop a strategy to use cardiac biomarkers in the evaluation of ACS.
3. Use recent research studies and guidelines to develop an approach to the patient with chest pain.

Contemporary Issues in End of Life Care (Oberlender)

Upon completion of this session, the participant should be able to: EBM, GL, COMP

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 based on current evidence-based literature, Guidelines and recommendations of the American Geriatrics Society and the National Hospice and Palliative Care Organization.
4. Relate dementia as a terminal illness.

A Practical Approach to Falls and Urinary Incontinence in the Elderly (Oberlender)             

Upon completion of this session, the participant should be able to: EBM, GL, COMP

1. Integrate the concept of multifactorial causes underlying falls and employ the American Geriatrics Society Guidelines for the Prevention of Falls and urinary 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 risk factors for falls and incontinence.
4. Apply NIH guidelines to formulate a preventative and therapeutic plan of care.

Improving Communication Skills in Medical Practice (Oberlender)

Upon completion of this session, the participant should be able to: COMP, ^

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 based on current literature.