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SPECIFIC OBJECTIVES - DAY 1 - ADULT PREVENTIVE HEALTH, PARTS I & II – Criteria for a good screening test. Rationale behind the recommended Health Maintenance Procedures. Recommended Health Maintenance Procedures including Screening, Counseling, Preventive Medications, and Immunizations. INCIDENTALOMAS – Prevalence of incidentally discovered masses of the adrenal, thyroid and pituitary glands. Differential diagnosis of these incidentally discovered masses. Evaluation strategy for incidentally discovered masses. GERD, CELIAC DISEASE AND NON-ULCER DYSPEPSIA – The varied presentation of GERD and Non-Ulcer Dyspepsia. Patients at risk for developing Barrett’s esophagus. Appropriate use of H. pylori testing in patients with dyspepsia. Algorithm for work-up and management of patients with dyspepsia. DAY 2 - PRIMARY CARE BASED MANAGEMENT OF CHF – Correctable causes of CHF. The “new paradigm” in CHF management addressing disease mechanisms. The role of new and old classes of drugs in CHF management. Develop a treatment plan for a patient with CHF. PAIN MANAGEMENT – The prevalence and importance of pain in the population. The different classes of pain medications and when to use each class of pain medication. Recognize and protect against the abuse of narcotic pain medications. Utilize adjuvant pain medications. UPDATE ON STDS IN PRIMARY CARE: WHAT’S NEW IN HSV AND HPV? – The transmission patterns of HSV. Diagnostic strategies for genital ulcers. Algorithm for managing patients with ASCUS Pap Smears. The role of HPV testing in reproductive age women. Recommendations for use of the HPV vaccine. HYPERTENSION – Current approach to the treatment of hypertension. Important aspects of the Joint National Committee recommendations for the individualized treatment of Hypertension. Which patients need further evaluation for secondary forms of hypertension. Advantages and disadvantages of home blood pressure monitoring. DAY 3 - MIGRAINE HEADACHES – Varied presentations of Migraine Headaches. Acute management of Migraine Headaches. When to institute prophylactic management for Migraine Headaches. Prophylactic strategy for patients with Migraine Headaches. ASTHMA AND COPD: UPDATES ON THERAPY – Application of guidelines for the management of asthma. Stratify patients with asthma according to severity of the illness. Predictive model for hospitalization in patients with acute asthma exacerbations. Which treatment elements improve efficiency of asthma management. Treatment plan for asthmatic patients using recently approved medications. DERMATOLOGY POTPOURRI – Common and important dermatologic illnesses. Common selected dermatologic illnesses. Which lesions need to be biopsied to make definitive diagnosis. PHARMACOTHERAPY OF DEPRESSION AND OTHER MOOD DISORDERS: INCORPORATING NEWER AGENTS AND STRATEGIES IN PRIMARY CARE – Epidemiology of depression and anxiety in primary care. The varied presentations of depression and anxiety in primary care. Treatment plan using newer anti-depressant medications. Treatment plan for patients who do not respond to the initial anti-depressant agent. DAY 4 - HYPERCHOLESTEROLEMIA – Current guidelines for stratification of risk in patients with hypercholesterolemia. Limitations of non-pharmacologic therapy in most patients with hypercholesterolemia. Treatment strategy using currently available medications for hypercholesterolemia. Strategy for monitoring and follow-up of patients treated for hypercholesterolemia. OSTEOPOROSIS – Prevalence of osteoporosis in a practice population and individuals at increased risk. Normal bone remodeling and the effect of hormonal changes on bone density. Appropriate and cost-effective laboratory studies for assessing bone health. Therapeutic plan for patients with osteoporosis using FDA-approved drugs. New directions in therapy for osteoporosis. TOP ARTICLES OF THE YEAR, PART I – New studies and articles that have come out with large importance to primary care medicine. Practice implications of these important new studies. Strengths and weaknesses of the research on which we will be basing our practices. TYPE 2 DIABETES – New American Diabetes Association recommendations for screening for diabetes. Current approach to drug therapy for patients with Type II Diabetes. Target levels for blood glucose control and hemoglobin A1C. Preventive health measures particularly for patients with Type II Diabetes, including screening for microalbinuria, diabetic foot exam, and ophthalmologic exams. DAY 5 - UPDATE ON THE DIAGNOSIS AND PREVENTION OF CORONARY HEART DISEASE IN WOMEN – Pathophysiology of acute coronary syndromes. Algorithm to stratify the mortality risk for patients with acute coronary syndromes. Treatment plan for patients with acute coronary syndromes. Use of anti-platelet medications and statins in acute coronary syndrome prevention. DEEP VENOUS THROMBOSIS AND PULMONARY EMBOLUS – When to use V/Q scans, pulmonary angiography, and non-invasive flow testing in the work-up of suspected pulmonary embolus. Interpret the results of these tests according to the pre-test probability of disease. Indications, contraindications, and therapeutic regimens for outpatient management of deep venous thrombosis with low-molecular weight heparin. How long anti-coagulation treatment should be continued after deep venous thrombosis. APPROACH TO THE PATIENT WITH CHRONIC HEPATITIS C VIRUS INFECTION – Epidemiology of hepatitis C. Patients at risk for hepatitis C. Diagnostic strategy for patients at risk. Management strategies and monitoring for patients with hepatitis C. TOP ARTICLES OF THE YEAR, PART II – New studies and articles that have come out with large importance to primary care medicine. Practice implications of these important new studies. Strengths and weaknesses of the research on which we will be basing our practices.
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