CME - Critical Care and Pulmonary Medicine: An Update and Review

Venue: Hyatt Sarasota on Sarasota Bay

Location: Sarasota, Florida, United States

Event Date/Time: Apr 28, 2008 End Date/Time: May 02, 2008
Early Registration Date: Mar 29, 2008
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SPECIFIC OBJECTIVES - DAY 1 - “NUTS AND BOLTS” OF PULMONARY FUNCTION TESTING – The Basics. - “Nuts and bolts” of pulmonary function testing with an emphasis on outpatient office spirometry. Components of PFTs including spirometry, lung volumes and diffusion. Indications for PFTs. Describe when bronchodilator and bronchoprovocation studies are useful. Approach to PFT interpretation and be able to distinguish common patterns. Different patterns of upper airway obstruction. A VARIETY OF ACTUAL PFTS WILL BE PRESENTED FOR INTERPRETATION AND REVIEW. ASTHMA UPDATE. - The current status of outpatient asthma diagnosis and treatment, emphasizing recent NIH guidelines. Pathophysiology of this inflammatory disease. Typical and atypical clinical presentations with cases serving as examples. Diagnostic modalities. Approach to treatment including bronchodilators, corticosteroids and methylxanthines. New agents and alternative therapies. Techniques to ensure patient compliance. Proper inhaler technique and peak flow monitoring. The patient who is not responding and indications for subspecialty referral. COPD - OVERVIEW OF PATIENT MANAGEMENT – PARTS I & II – Definition and pathophysiology of COPD. Natural history and clinical features of COPD. Adverse health effects of cigarette smoking and present recommendations for helping patients “kick the habit”. Aspects of outpatient management including long term oxygen therapy and pharmacologic treatment. A treatment algorithm and indications for specialist referral. Surgical treatment options for emphysema. DAY 2 - DISORDERS OF SLEEP – OBSTRUCTIVE SLEEP APNEA AND OTHERS – Epidemiology of obstructive sleep apnea. Clinical presentation and how to take a thorough “sleep history.” Diagnostic work-up including overnight polysomnography. Treatment modalities including CPAP, dental appliances, surgery & others. Obesity hypoventilation syndrome, central sleep apnea, Cheyne Stokes breathing, narcolepsy and periodic leg movements of sleep. PLEURAL DISEASES. - PLEURAL EFFUSIONS CAN BE CAUSED BY A WIDE VARIETY OF DISORDERS – Anatomy of the pleural space and the physiology of pleural fluid formation. Outline the imaging modalities available including plain chest radiography, ultrasonography and CT scanning. Indications and contraindications for thoracentesis. Characterize pleural fluid in a cost effective manner with an emphasis on differential diagnosis. Indications for pleural biopsy and diagnostic pleuroscopy. Treatment modalities available. Cases will be presented demonstrating some common and some not so common causes of pleural effusion. Recommendations on specialist referral will be provided. APPROACH TO THE PATIENT WITH CHRONIC COUGH – Pathophysiology and most common etiologies of cough. Features of a focused history and physical. Cost effective approach to diagnosis and treatment. PREOPERATIVE PULMONARY ASSESSMENT – Respiratory effects of anesthesia and surgery with emphasis on patients with at-risk complications. Perioperative risk factors associated with post-op pulmonary complications. Appropriate preoperative evaluation including the role of arterial blood gas measurement and spirometry. Preoperative measures that can minimize operative and postoperative respiratory complications. DAY 3 - APPROACH TO ACID-BASE DISTURBANCES – Primary metabolic and respiratory acid- base disturbances and their compensatory mechanisms. Approach to the interpretation of any acid-base problem. Differential diagnosis of the major simple and mixed acid-base disturbances. Illustrative case studies will be discussed. ACUTE RESPIRATORY FAILURE AND MECHANICAL VENTILATION – Pathophysiology and differential diagnosis of acute hypoxemic and hypersonic respiratory failure. Pathophysiology and differential diagnosis of acute respiratory failure. Concepts of management for patients on mechanical ventilation. Commonly used ventilator modes. Use of positive end expiratory pressure (PEEP). Indications for and complications of mechanical ventilation. Weaning, including general principles and strategies for weaning from mechanical ventilation. SHOCK AND HEMODYNAMIC MONITORING – Shock and the causes. The pathophysiology of common entities. Basic resuscitation techniques including volume replacement and the use of vasopressors. Review of early goal directed therapy. Current controversies surrounding the use of invasive hemodynamic monitoring. New treatments for septic shock. This will include the use of activated protein C and the role of corticosteroids. Critical Care Cases for Review; A variety of Critical Care cases will be presented with audience participation. X-rays and other diagnostic studies will be shown in an attempt to emphasize some of the common problems seen in the ICU. Cases will include a variety of pulmonary as well as non-pulmonary topics. DAY 4 - CRITICAL CARE CASES FOR REVIEW, PART II. A variety of Critical Care cases will be presented with audience participation. X-rays and other diagnostic studies will be shown in an attempt to emphasize some of the common problems seen in the ICU. Cases will include a variety of pulmonary as well as non-pulmonary topics. COMMUNITY ACQUIRED PNEUMONIA – Categorize patients with respect to severity of illness. Strategy to triage patients - outpatient therapy, hospitalize or ICU. Different pathogens that commonly cause community acquired pneumonia. Current status of diagnostic work-up including the use of cultures, gram stains, serology and bronchoscopy. We will emphasize a cost effective approach. Demonstrate how to properly use antibiotics for community acquired pneumonia. Old and new agents. Cases will be presented with chest x-rays and gram stains to illustrate important teaching points. TUBERCULOSIS – Epidemiology of tuberculosis. Clinical presentations including pulmonary, pleural and extrapulmonary tuberculosis. Identify ATS/CDC criteria for positive tuberculin skin test. Treatment of LTBI. The role of skin testing, sputum examination and bronchoscopy in diagnosis. Most recent ATS/CDC/IDSA Guidelines for TB therapy. Specific agents and their toxicities as well as formal treatment regimens. The problem of multi-drug resistant tuberculosis and implications for therapy. LUNG CANCER – Epidemiology of lung cancer. Major types of lung carcinoma, particularly small cell and non-small cell cancer. Basic clinical aspects of both small cell and non-small cell cancer including staging, natural history, and associated extrapulmonary syndromes. Diagnostic strategy for patients with suspected lung cancer. Current treatment options for small cell and non-small cell lung cancer. DAY 5 - HEMOPTYSIS – Causes for hemoptysis. Severity of a bleeding episode. Diagnostic modalities available. Acute basic therapy and indications for specialist referral. PULMONARY THROMBOEMBOLIC DISEASE – Epidemiology, risk factors, & clinical presentation of PE & DVT. Role of DVT prophylaxis and the current status of low molecular weight heparin. Diagram the diagnostic work-up including V/Q scanning, lower extremity studies, CT scanning, pulmonary angiography and others. Tx modalities including anticoagulation, thrombolysis & vena cava filters. INTERSTITIAL LUNG DISEASES – Spectrum of interstitial lung disease. Basic understanding of the diagnostic work-up, which can include high resolution CT scanning and tissue biopsy. Clinical and radiographic manifestations of sarcoidosis. Overview of management will be provided. Typical presentation of idiopathic pulmonary fibrosis as well as management issues. Presentation of Cases with x-rays, CT scans and pathology to illustrate important features. The discussion will focus on basic concepts and will include guidelines on specialist’s referral. PULMONARY CASES FOR REVIEW – Variety of cases will be discussed in order to review some of the important points outlined during the week. New information that was not formally covered in the previous sessions. The session will be interactive.


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Additional Information

Physician Fees $725.00 Regular Registration (30 days prior to seminar start date) $775.00 Late Registration Non Physician/Resident* Fees $625.00 Regular Registration (30 days prior to seminar start date) $675.00 Late Registration