Neurology and Rheumatology: A Practical Approach to Complex Specialties

Day 1

Rheumatoid Arthritis.

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

1. Demonstrate the role of genetics, environmental factors, immune cells, and proinflammatory cytokines in the pathogenesis of rheumatoid arthritis.
2. Illustrate the clinical features, extra-articular manifestations, and complications of rheumatoid arthritis.
3. Utilize and compare various methods of measuring disease activity in rheumatoid arthritis.
4. Compare and contrast the mechanisms of action of current and emerging therapies for RA and prescribe treatment for patients with rheumatoid arthritis according to ACR guidelines.

Rheumatologic Procedures.

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

1. Use techniques for appropriate indications for intra-articular and soft tissue injections in rheumatology.
2. Employ appropriate pharmacologic and non-pharmacologic therapies including injections for painful joints as per the ACR recommendations and the various sited rheumatologic and META analysis studies.

The Neurological Examination.

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

1. Organize the disparate parts of the neurologic examination into a personally relevant, manageable and reproducible diagnostic tool.
2. Perform a concise screening neurologic exam for asymptomatic patients.
3. Perform a problem-tailored neurologic exam for patients with neurologic complaints such as altered mental status and gait disturbances using evidence-based medicine.
4. Obtain maximum yield from the examination of a patient with an altered mental status.

Multiple Sclerosis.

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

1. Recognize the typical clinical features of multiple sclerosis.
2. Initiate an appropriate series of diagnostic investigations.
3. Formulate an approach to abortive and prophylactic therapy of multiple sclerosis using evidence-based medicine.
4. Anticipate common medical complications of multiple sclerosis.

Spondyloarthropathies.

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

1. Distinguish the clinical features of the different spondyloarthropathies to improve diagnostic accuracy.
2. Utilize clinical features, laboratory studies, and radiological studies to make a diagnosis of axial spondyloarthropathy.
3. Prescribe pharmacologic agents according to ACR and EULAR recommendations and evidence-based results from clinical trials for patients with spondyloarthropathies.

Day 2

Seizures and Epilepsy – Diagnosis.

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

1. Differentiate among the major types of seizures.
2. Apply epidemiologic aspects to the diagnosis of epilepsy.
3. Employ AAN and AES practice guidelines regarding sudden unexpected death in epilepsy. (SUDEP)
4. Distinguish seizures from syncope.
5. Formulate a plan for diagnostic investigation.

Seizures and Epilepsy – Management.

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

1. Determine when treatment with anticonvulsant medication is warranted using evidence-based medicine.
2. Choose among the many available anticonvulsant medications.
3. Manage problems confronted by women with epilepsy.
4. Counsel patients regarding their driving privileges.

Osteoarthritis.

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

1. Appraise the newer understandings of the pathophysiology of OA.
2. Distinguish the typical and atypical clinical features of OA.
3. Utilize the American College of Rheumatology guidelines for the treatment of OA of the hand, hip and knee.
4. Distinguish OA symptoms from those of other localized or generalized disorders.

Septic Arthritis.

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

1. Determine the risk factors associated with septic arthritis.
2. Utilize the British Society of Rheumatology Guidelines for management of the hot swollen joint in adults to differentiate septic arthritis from other causes of acute monoarticular arthritis.
3. Utilize epidemiological and clinical clues to determine bacterial etiology in patients with septic arthritis.

Psychogenic Neurologic Disorders.

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

1. Evaluate common neurologic manifestations of psychogenic disorders.
2. Distinguish among malingering, factitious disorders and conversion disorders.
3. Conduct an interview of a patient with a suspected psychogenic disorder.
4. Formulate a plan for management of a psychogenic illness.

Day 3

Lyme Disease and Other Topics in Rheumatology.

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

1. Apply CDC and Infectious Diseases Society of America Guidelines for the diagnosis, treatment, and prevention of Lyme disease.
2. Evaluate skin rashes as manifestations of systemic diseases.
3. Using the Guidelines of the Bone Research Society of the United Kingdom to prescribe appropriate therapy for patients with Paget’s disease of the Bone.

Idiopathic Inflammatory Myopathies.

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

1. Distinguish the different inflammatory myopathies as outlined in the 2017 European League Against Rheumatism/American College of Rheumatology Classification Criteria.
2. Utilize clinical features and appropriate testing to make the diagnosis of inflammatory myopathies.
3. Illustrate the pharmacologic agents used according to ACR and EULAR recommendations based upon evidence-based results from clinical trials for patients with idiopathic inflammatory myopathy.

Sleep Disorders – Insomnia and Obstructive Sleep Apnea.

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

1. Appraise the normal structure and function of stages of sleep.
2. Formulate a diagnostic and therapeutic approach to insomnia using best practice recommendations from the American Academy of Sleep Medicine and American Geriatric Society.
3. Detect clinical features and initiate management of sleep apnea.
4. Evaluate patients for comorbidities of obstructive sleep apnea.

Sleep Disorders – Restless Legs Syndrome, Narcolepsy and Others

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

1. Diagnose restless legs syndrome in under a minute.

2. Manage restless legs syndrome using practice guidelines.
3. Diagnose and treat narcolepsy.
4. Determine the prognosis of, and treat, REM-sleep behavior disorder.

Systemic Lupus Erythematosus.

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

1. Describe the varied clinical presentations and manifestations in the course of systemic lupus erythematosus.
2. Order and interpret laboratory testing used in the diagnosis of systemic lupus erythematosus in accordance with ACR Guidelines.
3. Monitor and employ treatment options for patients with systemic lupus erythematosus according to EULAR recommendations and evidence-based results from clinical studies.

Day 4

Dementia.

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

1. Evaluate patients with mild cognitive impairment or dementia.
2. Diagnose the major syndromes associated with common causes of dementia.
3. Distinguish the conditions that frequently mimic dementia.
4. Manage major complications of dementia.
5. Utilize the American Psychiatric Association practice guidelines for management of agitated dementia.

Parkinson’s Disease and Essential Tremor.

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

1. Assess the clinical features of the syndrome of parkinsonism.
2. Evaluate other important typical features of Parkinson’s disease.
3. Select treatment options for management of Parkinson’s disease.
4. Distinguish among common types of tremor and devise a therapeutic plan for a patient with essential tremor using American Academy of Neurology evidence-based guidelines.

Scleroderma and Raynaud’s Disease.

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

1. Specify the clinical manifestations of scleroderma.
2. Apply the ACR/EULAR classification criteria for systemic sclerosis.
3. Utilize treatment available for symptomatic manifestations as per the current EULAR recommendations.
4. Apply the diagnostic work-up and treatment of Raynaud’s Phenomenon.

Crystal Arthritis.

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

1. Describe the main clinical features associated with Crystal Arthritis
2. Gain insight into the pathophysiology of Crystal Arthritis
3. Discuss treatment modalities for Crystal Arthritis

Spasticity, Ataxia, and Gait Disorders.

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

1. Detect the major clinical features of spasticity.
2. Institute a diagnostic investigation of cervical spondylosis.
3. Assess ataxia and the other major clinical features of cerebellar dysfunction.
4. Evaluate different types of gait disorders.