Family Medicine and Internal Medicine: An Evidence - Based Approach

Day 1

Practical Approach to the Patient with Potential DVT (Horowitz)

Upon completion of this session, using multiple research trials as well as applying recommendations from the ACCP, AAFP/ACP, and the AHA/ACC, the participant should be able to: ^{GL, COMP}

1. Obtain an appropriate medical history to better identify those patients at risk.
2. More confidently evaluate and assess the patient suspected of having DVT.
3. Better manage patients with the confirmed diagnosis of DVT.

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.

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

Outpatient Anticoagulation Issues, Part 1 (Goldfinger)

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

1. Manage outpatients on warfarin using current CHEST guidelines and The Joint Commission 2023 National Patient Safety Goals.
2. Determine factors leading to alterations in the international normalized ratio (INR).
3. Advise patients on the appropriate choice, duration, and intensity of anticoagulation in a variety of clinical scenarios.
4. Develop a familiarity with the new oral anticoagulants.

Outpatient Anticoagulation Issues, Part 2 (Goldfinger)

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

1. Develop an evidence-based approach on perioperative management of antithrombotic and anticoagulant medications.
2. Recognize the proper use of IVC filters using evidence-based medicine.
3. Develop a practical approach when transitioning patients on and off anticoagulants or switching between anticoagulants.
4. Identify appropriate use of anticoagulant and antithrombic medications in combined therapy.

Day 2

Practical Approach to the Patient with Hyperlipidemia (Horowitz)

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

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

Preoperative Evaluation (Horowitz)

Evaluation of the Patient with Syncope. (Goldfinger)

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

1. Appraise the various etiologies of syncope.
2. Use clues in the history and physical as well as simple office testing to risk stratify patients with syncope.
3. Develop a plan for appropriate use of additional testing in patients with syncope to include indications for EP testing as per the AHA Syncope Algorithm and the ESC Guidelines.
4. Assess the role of lifestyle measures, medication, and more invasive measures to prevent recurrent syncope.

Peripheral Arterial Disease (PAD) – A Primary Care Perspective (Goldfinger)

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

1. Assess the relationship between PAD and other forms of atherosclerosis.
2. Determine which patients are at increased risk for PAD.
3. Perform a focused history and physical examination to assess for PAD.
4. Determine when to use ancillary testing.
5. Develop a plan for managing patients with PAD utilizing evidence-based ACC/AHA and CHEST guidelines for exercise, medications, and revascularization.

Drug Interactions and Side Effects (Goldfinger)

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

1. Determine the most common mechanisms for drug interactions.
2. Identify some of the most frequent culprit drugs such as Warfarin and Acetaminophen, AED’s, NSAIDs, and Statins.
3. Counsel patients regarding some of the most frequent side effects seen with commonly used medications.
4. Employ The Joint Commission 2023 Ambulatory Care National Patient Safety Goals.

Day 3

Practical Approach to Thyroid Disease: 1. Hypothyroidism/Elevated TSH 2. Patient with a Thyroid Nodule. (Horowitz)

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.

Strategies to Address the Issue of Preventable Hospital Readmissions (Horowitz)

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

1. Identify the factors which contribute to increase risk of readmission.
2. Stratify the risk for readmission utilizing evidence-based tools.
3. Develop a transition of care strategy to reduce the likelihood of a preventable readmission.

Diagnosis of Primary Headache Syndromes. (Smetana)

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

1. Distinguish among the historical features of migraine, tension-type, and cluster headaches.
2. Recognize which historical features best discriminate between migraine and tension-type headaches.
3. Apply the triggers for migraine to lifestyle modification.

Treatment of Primary Headache Syndromes. (Smetana)

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

1. Appreciate the role of abortive therapy for migraine, tension-type, and cluster headaches.
2. Recognize the range of options for pharmacologic acute and preventive therapy, as recommended by the AHS 2015 Evidence-Based recommendations for migraine, as well as options for tension-type, and cluster headaches.
3. Develop non-pharmacologic treatment strategies for migraine as per the most recent Cochrane Systematic Review.

Rational Management of Depression in Primary Care. (Smetana)

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

1. Employ an appropriate initial approach to use of the updated USPSTF Guidelines for screening of the patient with depression.
2. Determine the proper role of second generation antidepressants as per the ACP Guideline.
3. Assess the effectiveness of augmentation and switching strategies.
4. Specify the most common side effects, as per the 2016 ACP Guidelines, of commonly used antidepressants.

Day 4

Practical Approach to the Patient with Diabetes. (Horowitz)

Upon completion of this session, using multiple research trials as well as recommendations from the ADA, EASN, AGA, CDA, AACE, ACP, and the AAFP, the participant should be able to: ^{GL, COMP}

1. Consider this primer on management.
2. Distinguish the patient who is likely to go on to develop complications and appreciate the potential long-term course.
3. Apply the current guidelines for therapy and access the anticipated outcome goals.

Practical Approach to the Outpatient with Dementia. (Horowitz)

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.

Non-Surgical Approaches to the Patient with Obesity. (Horowitz)

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.

New Drugs for the Primary Care Physician: What You Need to Know. (Smetana)

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

1. Survey important advances in pharmacotherapy that pertain to primary care practice.
2. Discuss the efficacy and list the side effects for each drug.
3. Differentiate key new drugs with previously available medications for similar indications.

Hypertension: Recent Trials and Rational Therapy. (Smetana)

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

1. Appreciate that all antihypertensive medications do not equally reduce cardiovascular risk.
2. Apply the current JNC guidelines to clinical care of hypertensive patients.
3. Recognize compelling indications for selection of initial antihypertensive therapy.
4. Identify which drugs most effectively reduce the risk of cardiovascular disease.