Primary Care: A Family Medicine and Internal Medicine Update

Day 1

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: ^{EBM, GL, COMP}

1. Appraise patient specific data to determine if they meet diagnostic criteria for COPD.
2. Analyze the role of cigarette smoking in the etiology and natural history of COPD.
3. Formulate a treatment plan for the stages of COPD.
4. Recommend the follow-up required to assess the therapeutic efficacy of the treatment options.

Treating Patients with Type 2 Diabetes Mellitus.

Upon completion of this session, using the American Diabetes Association, the European Association for the Study of Diabetes Guidelines and the Cochrane Abstract Database, the participant should be able to: ^{EBM, GL, COMP}

1. Evaluate the therapeutic goals in treating type 2 diabetes and their impact on morbidity and mortality.
2. Recommend the approach for choosing an oral hypoglycemic agent to treat type 2 diabetes.
3. Specify 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.
4. Develop the therapeutic options for preventing diabetic complications.

Practical Approach to the Patient with Hyperlipidemia.

Upon completion of this session, using multiple research trials as well as the guideline-based recommendations, the participant should be able to: GL, COMP

1. Apply the current guidelines.
2. Develop a practical approach for considering the new medications available.
3. Consider the new targets developed for cholesterol end point.

 Practical Approach to the Patient with Hypertension.

Upon completion of this session, using multiple research trials as well as the guidelines, the participant should be able to: GL, COMP

1. Apply the current 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.

 Non-Surgical Approaches to the Patient with Obesity.

Upon completion of these sessions, 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: ^{GL, COMP}

1. Review the current popular diets available and marketed to your patients.
2. Take into consideration unique needs of the obese patient in order to create a comprehensive approach to the treatment of obesity.
3. Explain the basic physiology of obesity.
4. Manage the medications available for the treatment of obesity.

Day 2

Practical Approach to the Patient with Headache.

Upon completion of this session, while applying recommendations from the IHC, NHF, AAFP, AAN and ACP, the participant should be able to: ^{GL, COMP}

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.

 Approach to the Management of Stroke.

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.

 Treatment of Pain: Effective and Evidence-Based Strategies.

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

1. Implement general principles and goals for the treatment of pain.
2. Summarize the best practices for pharmacologic management of acute pain including potential benefits and risks of opioid analgesics.
3. Describe the cultural change in approach pain management.
4. Discuss the latest guidelines for pain management.
5. Apply nonpharmacologic pain management strategies.

 Depression and Anxiety in Primary Care.

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

1. Explain the incidence and prevalence of anxiety and depression.
2. Evaluate patients with signs and symptoms of anxiety and depression so as to make an accurate diagnosis as per the APA and DSM-5 Criteria.
3. Prescribe appropriate medications and/or behavior modification to treat the various degrees of anxiety and depression as well as bipolar disorder from initiation to continuation and maintenance, when needed

Ischemic Heart Disease in Women.

Upon completion of this session, using the American College of Cardiology, the American Heart Association, the USPSTF Guidelines and the Cochrane Abstract Database, the participant should be able to: ^{EBM,GL, COMP}

1. Differentiate the symptoms that women with coronary artery disease (CAD) exhibit in contrast to those experienced by men.
2. Recommend the evidence-based interventions to prevent CAD in women.
3. Formulate the recommendations to treat the risk factors for CAD in women.
4. Specify the treatment required for women with proven CAD.

Day 3

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: ^{EBM, GL, COMP}

1. Apply the evidence-based recommendations for preventive screening tests for adults.
2. Determine the immunizations required for adults.
3. Appraise the side effects of adult immunizations.
4. Select the contraindications for each adult immunization and their alternative therapy.
5. Plan when screening tests can be discontinued in adults.

 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: ^{EBM, GL, COMP}

1. Determine the diagnostic testing for evaluating a patient for possible VTE.
2. Apply the algorithm for diagnosing a pulmonary embolism in multiple clinical settings.
3. Differentiate the advantages and disadvantages of outpatient treatment compared to inpatient treatment for venous thromboembolism (VTE).
4. Order the frequency of monitoring and the adjustments needed for warfarin therapy in the treatment of VTE.

 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: ^{GL, COMP}

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.

 Practical 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: ^{GL, COMP}

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.

 Common Cases Walking Through Your Office Door.

Clinical Cases will be solicited throughout the week from the participants.  These cases will be selected and managed by the presenters. Diagnoses, next steps in management and expected clinical outcomes will be discussed.  The format will include panel discussion and audience participation.