Title: Internal Medicine – Hematology: Venous Thromboembolism; Anemia; Coagulopathy

Faculty: Kevin S. Ferentz, M.D., Joel Kravitz, M.D., F.A.C.E.P., F.R.C.P.S.C., Herbert L. Muncie, Jr. M.D.

Original Release Date: July 1, 2019  Expiration Date: July 1, 2022

TOPIC 1: 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.

TOPIC 2: Anemia.

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

1. Develop a diagnostic strategy to ascertain the etiology of the anemia.
2. Utilize the guidelines for diagnosing anemia in children and adults in terms of available testing.
3. Develop a clinical approach to treating various anemias to include Iron Deficiency and “Anemia of Chronic Disease” due to infections, inflammatory dz’s, CKD, Malignancies, Cytokines, Interferons, TNF’s, etc.
4. Describe the role of consultants in the evaluation and management of anemia.

TOPIC 3: Coagulopathy in the ER: All Bleeding Stops Eventually.

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

1. Differentiate different patterns of coagulopathy that present to the ED.
2. Develop an evaluation and treatment plan for non-traumatic bleeding disorders in the ED, including hemophilia, TTP, ITP and others.
3. Outline the rationale and indications for the use of blood products used in the treatment of the bleeding patient.
4. Discuss some of the newer anticoagulation agents used today, such as Prasugrel (Effient) and Dabigatran (Pradaxa), as per the referenced RCT’s and EBM studies such as Rocket, RE-LY and Einstein.

Title: Internal Medicine - EKG: AVRT (Atrioventricular Reentrant Tachycardia); Ischemia; ECG Interpretation Practice

Faculty: Jerry W. Jones, M.D., F.A.C.E.P., F.A.A.E.M.

Original Release Date: July 1, 2019  Expiration Date: July 1, 2022

Topic 1: Pre-excitation and AVRT (Atrioventricular Reentrant Tachycardia)

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

1. Detect positive and negative delta waves
2. Differentiate between a “by-stander” accessory pathway and a “circus movement” dysrhythmia
3. Differentiate between an AVNRT and an AVRT
4. Relate the inherent dangers of an accessory pathway

TOPIC 2: Ischemia: Subendocardial, Epicardial, Hyperacute T’s, Jones’s Sign (Jones’s Rule)

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

1. Differentiate between subendocardial ischemia and epicardial ischemia.
2. Analyze a 12-lead ECG for the earliest signs of myocardial ischemia.
3. Detect “Jones’s Sign” and assess minimal ST changes as possible early signs of ischemia.
4. Distinguish between inferior, anteroseptal (anteroapical), anterolateral and posterolateral epicardial ischemias.

TOPIC 3:   ECG Interpretation Practice.

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

1. Demonstrate the ability to utilize the Methodical Approach to 12-lead ECG interpretation while incorporating the “Three Main Causes” approach to assessing any abnormalities encountered during the interpretation
2. Demonstrate the ability to recognize the different forms of AV block and to differentiate 3rd degree AV block from simple AV dissociation
3. Specify the classic morphological features of left and right bundle branch block and the importance of the repolarization abnormality
4. Recognize the main categories of subendocardial and acute epicardial ischemia
5. Relate the importance and use of reciprocal changes in diagnosing acute epicardial ischemia

Title: Internal Medicine - Neurology: Dementia; Seizures/Epilepsy; Sleep Disorders

Faculty: David E. Riley, M.D.

Original Release Date: July 1, 2019  Expiration Date: July 1, 2022

TOPIC 1: Dementia.

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

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.

TOPIC 2: Seizures and Epilepsy – Diagnosis.

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

1. Differentiate among the major types of seizures.
2. Apply epidemiologic aspects to the diagnosis of epilepsy.
3. Distinguish seizures from syncope.
4. Formulate a plan for diagnostic investigation.

TOPIC 3: 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.
3. Diagnose and treat narcolepsy.
4. Determine the prognosis of, and treat, REM-sleep behavior disorder.

Title: Internal Medicine - Challenges: HIV, Immunocompromised Patient; Chronic Fatigue Syndrome

Faculty: Valerianna Amorosa, M.D., Stephen J. Gluckman, M.D., F.A.C.P., F.I.D.S.A., Jerry Zuckerman, M.D.

Original Release Date: July 1, 2019  Expiration Date: July 1, 2022

TOPIC 1: HIV Primer for the Primary Care Physician.

Using recommendations and evidence-based guidelines from IDSA, HIVMA, USPHS, CDC and ACP, upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Relate the latest epidemiology of HIV infection.
2. Interpret recommendations for HIV screening.
3. Interpret diagnostic tests (e.g. viral load, CD4 count) and apply them to HIV management.
4. Illustrate the principles of antiretroviral treatment.

TOPIC 2: Infections in the Immunocompromised Patient.

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

1. Appraise the immunocompromised patient who is at most risk for serious infections due to diabetes, malignancy, and chemotherapy or medications such as the immunomodulators as per the published EBM/RCT studies in Diabetes Care, Infectious Disease Clinics N.A., Journal of Rheumatology and others.
2. Employ standard of appropriate preventative care in various immunocompromised populations seen in primary care.
3. Apply an approach to the treatment and follow up of these infections for each type of at risk patient.

TOPIC 3: Chronic Fatigue Syndrome.

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

1. Demonstrate how to diagnose CFS and how to distinguish it from chronic fatigue.
2. Relate the history of CFS.
3. Determine the management and how not to mismanage, a patient with CFS as per the current Institute of Medicine Diagnostic Criteria.

Title: Internal Medicine - Cases: Rheumatology Cases; Dermatology Cases; Critical Care Cases

Faculty: Jeffrey Miller, M.D., M.B.A, William T. Ayoub, M.D., F.A.C.P., F.A.C.R., Arshad A. Wani, M.D.

Original Release Date: July 1, 2019  Expiration Date: July 1, 2022

TOPIC 1: Case Studies.

Upon completion of these sessions, the participant should be able to:

1. Apply the concepts presented in the Rheumatology section of this conference to effectively deal with cases presentations
2. Identify several less common causes of musculoskeletal symptoms and signs.

TOPIC 2: Evidence-Based Case Studies in Dermatology.

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

1. Formulate evidence-based treatment for photo-damaged skin.
2. Formulate evidence-based treatment for common skin diseases, such as: molluscum contagiosum and pityriasis rosea.
3. Assess the one side effect of isotretinoin therapy that predicts higher risk for future hyperlipidemia.

TOPIC 3: Critical Care Cases for Review.

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

1. Detect acute liver failure (ALF) and develop appropriate plans for management of ALF and acetaminophen OD.
2. Detect pulmonary edema in the ICU and formulate a plan for the management of ARDS.
3. Integrate the management of a patient with cardiac arrest based on AHA-ACLS Guidelines with consideration for therapeutic hypothermia and develop a brain death protocol.